The cost-effectiveness of a smoking cessation program for out-patients in treatment for depression.

AIMS: Smoking cessation programs are highly cost-effective. The cost-effectiveness of programs for psychiatric patients may be affected by differences in cost, efficacy, survival and quality of life. We evaluated cost-effectiveness of a program for smokers being treated for depression. DESIGN: A ran...

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Published in:Addiction Vol. 103; no. 5; pp. 834 - 841
Main Authors: Barnett PG, Wong W, Hall S
Format: clinical trial research tables/charts Journal Article
Published: Wiley-Blackwell May2008
Online Access:View this record in EBSCOhost
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      dt: May2008
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/j.1360-0443.2008.02167.x
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        atl: The cost-effectiveness of a smoking cessation program for out-patients in treatment for depression.
      aug:
        au:
          Barnett PG
          Wong W
          Hall S
        affil: Department of Psychiatry, University of California, San Francisco, CA, USA. paul.barnett@va.gov
      sug:
        subj:
          Cost Benefit Analysis
          Depression Therapy
          Mental Health Services Economics
          Smoking Cessation Programs Economics
          Adult
          Clinical Trials
          Comparative Studies
          Current Procedural Terminology
          Descriptive Statistics
          Female
          Funding Source
          Health Care Costs
          Health Resource Utilization
          Insurance, Health, Reimbursement
          Interviews
          Male
          Medicare
          Middle Age
          Outpatients
          Psychological Tests
          Self Report
          Wilcoxon Rank Sum Test
          Human
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: AIMS: Smoking cessation programs are highly cost-effective. The cost-effectiveness of programs for psychiatric patients may be affected by differences in cost, efficacy, survival and quality of life. We evaluated cost-effectiveness of a program for smokers being treated for depression. DESIGN: A randomized trial compared brief contact to a stepped smoking cessation program in 322 cigarette smoking mental health out-patients. We determined the intervention's direct cost. Because smoking cessation may affect short-term use of mental health care, we used administrative databases and self-report to find mental health-care cost. FINDINGS: The 163 individuals randomized to stepped care received an average of $346 of smoking cessation services, including $221 for computer-mediated assessments of readiness to quit, and $124 for counseling, nicotine replacement therapy and bupropion. The cessation program was used by 53 participants. Total cost of smoking cessation and mental health services was $4805 in the stepped care group and $4173 in the brief-contact care group (not significantly different). After 18 months of follow-up, the stepped care group had 5.5% greater abstinence from smoking. Smoking cessation services cost $6204 per successful quit. Cessation services and mental health care cost was $11 496 per successful quit. CONCLUSION: If smoking cessation yields 1.2 years additional life, the cessation services cost $5170 per life-year, and cessation services and mental health care cost $9580 per life-year. Even if quitting does not increase survival of depressed individuals as well as in other smokers, the stepped care intervention is likely to be regarded as cost-effective.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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