The potential of smoking cessation programmes and a smoking ban in public places: Comparing gain in life expectancy and cost effectiveness

• Published in: Scandinavian journal of public health Vol. 39; no. 8; pp. 785 - 796
• Main Authors: HØJGAARD, BETINA, OLSEN, KIM ROSE, PISINGER, CHARLOTTA, TØNNESEN, HANNE, GYRD-HANSEN, DORTE
• Format: Journal Article
• Language: English
• Published: London, England SAGE 01-12-2011; SAGE Publications; Sage Publications
• Subjects: Adolescent; Adult; Biological and medical sciences; Cessation; Cost effectiveness; Cost Savings; Cost-Benefit Analysis; Denmark; Health Care Costs; Health economics; Health expenditure; Humans; Interventions; Life Expectancy; Markov Chains; Medical sciences; Miscellaneous; Original articles; Prevention and actions; Program Evaluation; Public finance; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Public places; Public spaces; Regulation; Restaurants - legislation & jurisprudence; Short term; Smoking; Smoking - economics; Smoking - legislation & jurisprudence; Smoking Cessation - economics; Smoking Prevention; Strategic planning; Tobacco Smoke Pollution - economics; Tobacco Smoke Pollution - legislation & jurisprudence; Tobacco Smoke Pollution - prevention & control; Tobacco, tobacco smoking; Toxicology; Workplace - legislation & jurisprudence; Costs and cost analysis; preventive health services; public health; smoking; Life expectancy; Poison withdrawal; Anti-smoking fight; Tobacco smoking; Health service; Smoke-free space; Prevention; Public place; Tobacco; Shutdown; Health economy; Cost analysis; Comparative study; Gain; Public health; Cost efficiency analysis
• ISSN: 1403-4948; 1651-1905
• DOI: 10.1177/1403494811421416

Background: Interventions aimed at reducing the number of smokers are generally believed to be cost effective. However as the cost of the interventions should be paid up front whereas the gains in life years only appear in the future - the budgetary consequences might be a barrier to implementing such interventions. Aims: The aim of the present paper was to assess the long-term cost effectiveness as well as the short-term (10 years) budget consequences of cessation programmes and a smoking ban in enclosed public places. Methods: We develop a population-based Markov model capable of analyzing both interventions and assess long-term costs effectiveness as well as short-term budgetary consequences and outcome gains. The smoking cessation programme model was based on data from the Danish National Smoking Cessation Database (SCDB), while the model of the smoking ban was based on effect estimates found in the literature. Results: On a population level the effect of a smoking ban has the largest potential compared with the effect of smoking cessation programmes. Our results suggest that smoking cessation programmes are cost saving and generate life-years, whereas the costs per life-year gained by a smoking ban are 40,645 to 645462DKK (100 DKK = €13.4). These results are conservative as they do not include the healthcare cost saving related to reduced passive smoking. Conclusions: Our results indicate that smoking cessation programmes and a smoking ban in enclosed public places both in the short term and the long term are costeffective strategies compared with the status quo.