BACKGROUND: The provision of cessation services remains uneven globally. Improvements in global cessation require sustained efforts and investments. Few studies have been conducted in China to evaluate the economics of comprehensive community-based smoking cessation interventions. Based on a multicenter study in five Chinese cities, this study analyzes the costs and benefits of community-based cessation interventions from a healthcare perspective to provide an evidence-based basis for decision-making in the health sector.
METHODS: Qingdao, Qinhuangdao, Changsha, Xuchang, and Yinchuan cities were selected. In each city, community-level tobacco control publicity and intensive cessation services were used in the 10 intervention groups, while self-help cessation materials were distributed in the 10 control groups. The effectiveness of the intervention was evaluated, per capita intervention costs and smoking-related health status indicators were also collected through qualitative interviews and literature review. A multi-state Markov model was constructed to analyze Incremental Cost-Utility Ratio (ICUR).
RESULTS: A total of 2778 smokers were included, 1382 in the intervention group and 1396 in the control group, with a 6-month sustained quit rate of 14.91% and 1.79% respectively. There was a statistically significant difference between the two groups (p<0.05). The total cost of implementing the smoking cessation intervention was ￥688.165.388 with a total utility of 27.051 QALYs, and ￥690.270.387 with a total utility of 27.014 QALYs respectively. Compared with the control group, the implementation of the smoking cessation intervention saved cost of ￥2.104.999, with an incremental utility of 0.037 QALYs. The ICUR was -56806.618, which was less than 1x GDP per capita in 5 cities, indicating that the implementation of smoking cessation intervention was very economical.
CONCLUSIONS: The implementation of a comprehensive community-based smoking cessation intervention is highly cost-effective and can significantly reduce the economic and social burden of smoking-related diseases and deaths, which should be popularized and widely implemented nationwide.