Cost-effectiveness of a hospital-based smoking cessation intervention

Med Care. 1998 May;36(5):670-8. doi: 10.1097/00005650-199805000-00007.


Objectives: This study evaluated the cost-effectiveness of a smoking cessation and relapse-prevention program for hospitalized adult smokers from the perspective of an implementing hospital. It is an economic analysis of a two-group, controlled clinical trial in two acute care hospitals owned by a large group-model health maintenance organization. The intervention included a 20-minute bedside counseling session with an experienced health counselor, a 12-minute video, self-help materials, and one or two follow-up calls.

Methods: Outcome measures were incremental cost (above usual care) per quit attributable to the intervention and incremental cost per discounted life-year saved attributable to the intervention.

Results: Cost of the research intervention was $159 per smoker, and incremental cost per incremental quit was $3,697. Incremental cost per incremental discounted life-year saved ranged between $1,691 and $7,444, much less than most other routine medical procedures. Replication scenarios suggest that, with realistic implementation assumptions, total intervention costs would decline significantly and incremental cost per incremental discounted life-year saved would be reduced by more than 90%, to approximately $380.

Conclusions: Providing brief smoking cessation advice to hospitalized smokers is relatively inexpensive, cost-effective, and should become a part of the standard of inpatient care.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Chi-Square Distribution
  • Cost-Benefit Analysis
  • Female
  • Hospital Costs
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Oregon
  • Outcome Assessment, Health Care / statistics & numerical data
  • Public Health
  • Secondary Prevention
  • Smoking Cessation / economics*
  • Value of Life
  • Washington