Clinical study
Cost-effectiveness of a smoking cessation program after myocardial infarction

https://doi.org/10.1016/0735-1097(93)90598-UGet rights and content
Under a Creative Commons license
open archive

Abstract

Objectives. The purpose of this study was to evaluate the cost-effectiveness of a smoking cessation program initiated after acute myocardial infarction.

Background. The value of allocating health care resources to smoking cessation programs after myocardial infarction has not been compared with the value of other currently accepted interventions.

Methods. A model was developed to examine the cost-effectiveness of a recently reported smoking cessation program after an acute myocardial infarction. The cost was estimated by considering the resources necessary to implement the program, and the effectiveness was expressed as discounted years of life saved. Years of life saved were estimated by modeling life expectancy using a single declining exponential approximation of life expectancy based on data from published reports.

Results. The cost-effectiveness of the nurse-managed smoking cessation program was estimated to be $220/year of life saved. In a one-way sensitivity analysis, the cost-effectiveness of the program remained <$20,000/year of life saved if the program decreased the smoking rate by only 3/1,000 smokers (baseline assumption 26/100 smokers), or if the program cost as much as $8,840/smoker (baseline assumption $100). In a two-way sensitivity analysis, even if the cost of the program were as high as $2,000/participant, the cost-effectiveness of the program would be <$10,000/year of life saved so as the an program helped an additional 12 smokers quit for every 100 enrolled.

Conclusions. Over a wide range of estimates of costs and effectiveness, a nurse-managed smoking cessation program after acute myocardial infarction is an extremely cost-effective intervention. This program is more cost-elective than beta-adrenergic antagonist therapy after myocardial infarction.

Cited by (0)

This study was supported in part by Training Grant LM7044 from the National Library of Medicine, Bethesda, Maryland and Grant HL07374 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, and by the Institute of Respiratory Diseases Foundation, Sarasota, Florida.