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. 2001 Sep;155(9):1043-50.
doi: 10.1001/archpedi.155.9.1043.

Cost-effectiveness of a school-based tobacco-use prevention program

L Y Wang  1 , L S Crossett, R Lowry, S Sussman, C W Dent
Affiliations

Cost-effectiveness of a school-based tobacco-use prevention program

L Y Wang et al. Arch Pediatr Adolesc Med. 2001 Sep.

Abstract

Objective: To determine the cost-effectiveness of a school-based tobacco-use prevention program.

Design: Using data from the previously reported 2-year efficacy study of the Project Toward No Tobacco Use (TNT), we conducted a decision analysis to determine the cost-effectiveness of TNT. The benefits measured were life years (LYs) saved, quality-adjusted life years (QALYs) saved, and medical care costs saved, discounted at 3%. The costs measured were program costs. We quantified TNT's cost-effectiveness as cost per LY saved and cost per QALY saved.

Intervention: A 10-lesson curriculum designed to counteract social influences and misconceptions that lead to tobacco use was delivered by trained health educators to a cohort of 1234 seventh-grade students in 8 junior high schools. A 2-lesson booster session was delivered to the eighth-grade students in the second year. The efficacy evaluation was based on 770 ninth-grade students who participated in the program in the seventh and eighth grades and in both the baseline and the 2-year follow-up survey.

Results: Under base case assumptions, at an intervention cost of $16 403, TNT prevented an estimated 34.9 students from becoming established smokers. As a result, we could expect a saving of $13 316 per LY saved and a saving of $8482 per QALY saved. Results showed TNT to be cost saving over a reasonable range of model parameter estimates.

Conclusions: The TNT is highly cost-effective compared with other widely accepted prevention interventions. School-based prevention programs of this type warrant careful consideration by policy makers and program planners.

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