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Randomized Controlled Trial
. 2013 Nov;22(6):e11.
doi: 10.1136/tobaccocontrol-2012-050465. Epub 2012 Sep 25.

Cost-effectiveness of internet and telephone treatment for smoking cessation: an economic evaluation of The iQUITT Study

Amanda L Graham  1 , Yaojen Chang, Ye Fang, Nathan K Cobb, David S Tinkelman, Raymond S Niaura, David B Abrams, Jeanne S Mandelblatt
Affiliations
Randomized Controlled Trial

Cost-effectiveness of internet and telephone treatment for smoking cessation: an economic evaluation of The iQUITT Study

Amanda L Graham et al. Tob Control. 2013 Nov.

Abstract

Background: Internet and telephone treatments for smoking cessation can reach large numbers of smokers. There is little research on their costs and the impact of adherence on costs and effects.

Objective: To conduct an economic evaluation of The iQUITT Study, a randomised trial comparing Basic Internet, Enhanced Internet and Enhanced Internet plus telephone counselling ('Phone') at 3, 6, 12 and 18 months.

Methods: We used a payer perspective to evaluate the average and incremental cost per quitter of the three interventions using intention-to-treat analysis of 30-day single-point prevalence and multiple-point prevalence (MPP) abstinence rates. We also examined results based on adherence. Costs included commercial charges for each intervention. Discounting was not included given the short time horizon.

Results: Basic Internet had the lowest cost per quitter at all time points. In the analysis of incremental costs per additional quitter, Enhanced Internet+Phone was the most cost-effective using both single and MPP abstinence metrics. As adherence increased, the cost per quitter dropped across all arms. Costs per quitter were lowest among participants who used the 'optimal' level of each intervention, with an average cost per quitter at 3 months of US$7 for Basic Internet, US$164 for Enhanced Internet and US$346 for Enhanced Internet+Phone.

Conclusions: 'Optimal' adherence to internet and combined internet and telephone interventions yields the highest number of quitters at the lowest cost. Cost-effective means of ensuring adherence to such evidence-based programmes could maximise their population-level impact on smoking prevalence.

Keywords: Cessation; Economics; Media.

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Conflict of interest statement

Competing interests Cobb is a consultant to Healthways Inc, which operates QuitNet, a web-based smoking cessation application using social networks. Tinkelman is medical director of the National Jewish Health QuitLine, and vice president of Health Initiatives for National Jewish which owns the QuitLine.

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