Cost-effectiveness analysis of smoking cessation interventions using cell phones in a low-income population

Allan T. Daly, Ashish A. Deshmukh, Damon J. Vidrine, Alexandre V Prokhorov, Summer G. Frank, Patricia D. Tahay, Maggie E. Houchen, Scott B Cantor

Research output: Contribution to journalArticle

Abstract

Background The prevalence of cigarette smoking is significantly higher among those living at or below the federal poverty level. Cell phone-based interventions among such populations have the potential to reduce smoking rates and be cost-effective. Methods We performed a cost-effectiveness analysis of three smoking cessation interventions: Standard Care (SC) (brief advice to quit, nicotine replacement therapy and self-help written materials), Enhanced Care (EC) (SC plus cell phone-delivered messaging) and Intensive Care (IC) (EC plus cell phone-delivered counselling). Quit rates were obtained from Project ACTION (Adult smoking Cessation Treatment through Innovative Outreach to Neighborhoods). We evaluated shorter-term outcomes of cost per quit and long-term outcomes using cost per quality-adjusted life year (QALY). Results For men, EC cost an additional $541 per quit vs SC; however, IC cost an additional $5232 per quit vs EC. For women, EC was weakly dominated by IC-IC cost an additional $1092 per quit vs SC. Similarly, for men, EC had incremental cost-effectiveness ratio (ICER) of $426 per QALY gained vs SC; however, IC resulted in ICER of $4127 per QALY gained vs EC. For women, EC was weakly dominated; the ICER of IC vs SC was $1251 per QALY gained. The ICER was below maximum acceptable willingness-to-pay threshold of $50 000 per QALY under all alternative modelling assumptions. Discussion Cell phone interventions for low socioeconomic groups are a cost-effective use of healthcare resources. Intensive Care was the most cost-effective strategy both for men and women. Trial registration number NCT00948129; Results.

LanguageEnglish (US)
Pages88-94
Number of pages7
JournalTobacco control
Volume28
Issue number1
DOIs
StatePublished - Jan 1 2019

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Cell Phones
cell phone
Smoking Cessation
Poverty
Critical Care
Cost-Benefit Analysis
smoking
low income
Quality-Adjusted Life Years
Costs and Cost Analysis
costs
Standard of Care
Smoking
Withholding Treatment
Nicotine
Counseling
Delivery of Health Care

Keywords

  • community outreach
  • cost and cost analysis
  • decision making
  • mobile clinic
  • smoking cessation
  • underserved populations

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health

Cite this

Cost-effectiveness analysis of smoking cessation interventions using cell phones in a low-income population. / Daly, Allan T.; Deshmukh, Ashish A.; Vidrine, Damon J.; Prokhorov, Alexandre V; Frank, Summer G.; Tahay, Patricia D.; Houchen, Maggie E.; Cantor, Scott B.

In: Tobacco control, Vol. 28, No. 1, 01.01.2019, p. 88-94.

Research output: Contribution to journalArticle

Daly, Allan T. ; Deshmukh, Ashish A. ; Vidrine, Damon J. ; Prokhorov, Alexandre V ; Frank, Summer G. ; Tahay, Patricia D. ; Houchen, Maggie E. ; Cantor, Scott B. / Cost-effectiveness analysis of smoking cessation interventions using cell phones in a low-income population. In: Tobacco control. 2019 ; Vol. 28, No. 1. pp. 88-94.
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AB - Background The prevalence of cigarette smoking is significantly higher among those living at or below the federal poverty level. Cell phone-based interventions among such populations have the potential to reduce smoking rates and be cost-effective. Methods We performed a cost-effectiveness analysis of three smoking cessation interventions: Standard Care (SC) (brief advice to quit, nicotine replacement therapy and self-help written materials), Enhanced Care (EC) (SC plus cell phone-delivered messaging) and Intensive Care (IC) (EC plus cell phone-delivered counselling). Quit rates were obtained from Project ACTION (Adult smoking Cessation Treatment through Innovative Outreach to Neighborhoods). We evaluated shorter-term outcomes of cost per quit and long-term outcomes using cost per quality-adjusted life year (QALY). Results For men, EC cost an additional $541 per quit vs SC; however, IC cost an additional $5232 per quit vs EC. For women, EC was weakly dominated by IC-IC cost an additional $1092 per quit vs SC. Similarly, for men, EC had incremental cost-effectiveness ratio (ICER) of $426 per QALY gained vs SC; however, IC resulted in ICER of $4127 per QALY gained vs EC. For women, EC was weakly dominated; the ICER of IC vs SC was $1251 per QALY gained. The ICER was below maximum acceptable willingness-to-pay threshold of $50 000 per QALY under all alternative modelling assumptions. Discussion Cell phone interventions for low socioeconomic groups are a cost-effective use of healthcare resources. Intensive Care was the most cost-effective strategy both for men and women. Trial registration number NCT00948129; Results.

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