Cost-effectiveness of pharmacy and group behavioural support smoking cessation services in Glasgow.

AIMS:

Smokers attending group-based support for smoking cessation in Glasgow are significantly more likely to be successful than those attending pharmacy-based support. This study examined the cost-effectiveness of these two modes of support.

DESIGN:

Combination of observational study data and information from National Health Service (NHS) Greater Glasgow and Clyde smoking cessation services.

SETTING:

Glasgow, Scotland.

PARTICIPANTS:

A total of 1979 smokers who accessed either of the cessation services between March and May 2007.

INTERVENTION:

Two smoking treatment services offering one-to-one support in pharmacies, and providing group counselling in the community.

MEASUREMENTS:

Routine monitoring data on resource use and smoking status (carbon monoxide-validated, self-reported, non-quitters and relapsers) at 4-week follow-up.

FINDINGS:

The incremental cost per 4-week quitter for pharmacy support was found to be approximately 772 pounds sterling, and 1612 pounds sterling for group support, in comparison to self-quit cessation attempts. These findings compare favourably with previously published outcomes from cost-effectiveness smoking cessation studies. Assuming a relapse rate of 75% from 4 weeks to 1 year and a further 35% beyond 1 year, and combining this with an average of 1.98 quality adjusted life years (QALY) gained per permanent cessation, provides an estimated incremental cost per QALY of 4400 pounds sterling for the pharmacy service and 5400 pounds sterling for group support service.

CONCLUSIONS:

Group support and pharmacy-based support for smoking cessation are both extremely cost-effective.