Li, Jinshuo orcid.org/0000-0003-1496-7450, Wu, Qi orcid.org/0000-0002-8281-7799, Parrott, Steve orcid.org/0000-0002-0165-1150 et al. (17 more authors) (2024) Cost-utility analysis of provision of e-cigarette starter kits for smoking cessation in emergency departments:An economic evaluation of a randomized controlled trial. Addiction. ISSN 1360-0443
Abstract
Aims: To assess the cost-effectiveness of the Cessation of Smoking Trial in Emergency Department (COSTED) intervention compared with signposting to local stop smoking service (SSS) from the National Health Service (NHS) and personal social services (PSS) perspective. Design, setting and participants: This was a two-group, multi-centre, pragmatic, individually randomized controlled trial set in six Emergency Departments (EDs) in urban and rural areas in the United Kingdom. Adult (≥ 18 years) daily smokers (at least one cigarette or equivalent per day) but not daily e-cigarette users, with carbon monoxide reading ≥ 8 parts per million, attending the ED (n = 972) were included. The intervention consisted of provision of an e-cigarette starter kit plus brief smoking cessation advice and referral to a local SSS. Control was an information card on how to access local SSS. Measurements: Intervention costs included costs of training and delivery. Control costs included costs of printing information cards. Costs of smoking cessation and health-care services were estimated based on quantities reported by participants and unit costs extracted from secondary sources. The effects were measured by quality-adjusted life years (QALYs) derived from EQ-5D-5L. Other outcomes were smoking cessation measures. The primary outcome was incremental cost-effectiveness ratio (ICER), which was calculated by dividing the difference in costs by the difference in QALYs between groups. Findings: The mean intervention costs were £48 [standard error (SE) = £0] per participant and the mean control costs were £0.2 (SE = £0) per participant. Using regression estimates, total costs were £31 [95% confidence interval (CI) = -£341 to £283] higher and 6-month QALYs were 0.004 (95% CI = -0.004 to 0.014) higher in the intervention group than in the control group. The ICER was calculated at £7750 (probability of cost-effective at range £20 000-30 000: 72.2-76.5%). Conclusions: The UK Cessation of Smoking Trial in Emergency Department (COSTED) intervention (provision of an e-cigarette starter kit plus brief smoking cessation advice) was cost-effective compared with signposting to local stop smoking services under the current recommendations of the maximum acceptable thresholds. Keywords: Brief intervention; Markov model; cost‐effectiveness; economic evaluation; emergency department; e‐cigarette; life‐time modelling; randomized controlled trial; smoking cessation.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2024 The Author(s). |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Sciences (York) > Health Sciences (York) |
Funding Information: | Funder Grant number NETSCC NIHR129438 |
Depositing User: | Pure (York) |
Date Deposited: | 15 Nov 2024 15:20 |
Last Modified: | 02 Apr 2025 23:28 |
Published Version: | https://doi.org/10.1111/add.16698 |
Status: | Published online |
Refereed: | Yes |
Identification Number: | 10.1111/add.16698 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:219723 |
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Description: Addiction - 2024 - Li - Cost utility analysis of provision of e‐cigarette starter kits for smoking cessation in emergency
Licence: CC-BY 2.5