A mass media programme to prevent smoking among adolescents: costs and cost effectiveness

Abstract

Objective: To examine costs and cost-effectiveness ratios of a four-year mass media programme previously shown to prevent the onset of smoking among adolescents.

Design: A matched control design.

Setting: Two cities in Montana, one in New York and one in Vermont, USA.

Subjects: Students in grades 10-12 (ages 15-18).

Intervention: A four-year mass media campaign to prevent the onset of smoking.

Main outcome measures: Cost per student potentially exposed to the mass media campaign; cost per student smoker potentially averted; and cost per life-year gained. Cost estimates were also made for a similar campaign that would be broadcast nationally in the United States.

Results: In 1996 dollars, the cost of developing and broadcasting the mass media campaign was $759,436, and the cost per student potentially exposed to the campaign (n = 18,600) was $41. The cost per student smoker averted (n = 1023) was $754 (95% confidence interval (CI) = $531-$1296). The cost per life-year gained discounted at 3% over the life expectancy for young adult smokers was $696 (95% CI = $445-$1269). The estimated cost of developing and broadcasting a similar four-year mass media campaign in all 209 American media markets would be approximately $84.5 million, at a cost of $8 per student potentially exposed to a national campaign, $162 per student smoker averted, and $138 (95% CI = $88-$252) per life-year gained.

Conclusion: Estimates of the cost-effectiveness ratios of this mass media campaign in preventing the onset of smoking showed it to be economically attractive and to compare favourably with other preventive and therapeutic strategies.