The first assessment in the EU of interventions to help people quit smoking and the comparative cost effectiveness of different approaches shows that all current interventions are more cost-effective than trying to stop without assistance.
As a result, the Health Information and Quality Authority (HIQA) made a set of recommendations and policy guidelines to the minister of health Simon Harris about which cessation programmes provide best value for money and most optimal outcomes.
The report recommends the prescription medication varenicline either alone or in combination with nicotine replacement therapy as the most cost-effective type of pharmacological support. Although e-cigarettes, used as a cessation aid by almost a third of smokers in Ireland, are twice as effective as placebo, varenicline and combinatorial therapies offer better value for money and better outcomes.
The report also recommends counselling and group behaviour therapies, as a cost-effective complement to conventional cessation programmes. The availability of behavioural therapy is particularly important for pregnant women who smoke and other vulnerable cohorts of population.
Given that 20 per cent of deaths each year are attributable to direct or second-hand smoking, policy reforms to put in place more efficient smoking cessation programmes are an important step to sustainable healthcare.
From the report: “Quitting smoking is a complex, iterative process in which the choice of cessation intervention is only one of many factors that influence outcomes. However, there is good evidence that cessation rates can be improved if smokers choosing to make an assisted attempt to stop smoking are encouraged to use more effective interventions. A cost-effectiveness analysis of individual therapies found that while all treatments under consideration were cost-effective compared to attempting to stop without assistance, e-cigarettes and varenicline, alone or in combination with NRT, provide the best value for money.
Cost-effectiveness plane for the comparison of single smoking cessation interventions on QALY (Quality-adjusted life years) outcomes
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