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Nicotine Dependence and Cost-Effectiveness of Individualized Support for Smoking Cessation: Evidence from Practice at a Worksite in Japan

Author

Listed:
  • Koshi Nakamura
  • Masaru Sakurai
  • Katsuyuki Miura
  • Yuko Morikawa
  • Shin-ya Nagasawa
  • Masao Ishizaki
  • Teruhiko Kido
  • Yuchi Naruse
  • Yasushi Suwazono
  • Hideaki Nakagawa

Abstract

Given the lack of economic studies evaluating the outcomes of smoking cessation programs from the viewpoint of program sponsors, we conducted a case study to provide relevant information for worksites. The present study was carried out between 2006 and 2008 at a manufacturing factory in the Toyama Prefecture of Japan and included subjects who voluntarily entered a smoking cessation program. The program included face-to-face counselling followed by weekly contact to provide encouragement over six months using e-mail or inter-office mail. Nicotine patches were available if required. All 151 participants stopped smoking immediately. Over the 24-month study period, self-report showed 49.7% abstained continuously from smoking. The rate of 24-month consecutive abstinence was higher in participants with lower Fagerström Test scores for Nicotine Dependence at baseline than in those with higher scores (63.6% for 0–2 points vs. 46.5% for 3–6 points vs. 43.8% for 7–10 points; chi-square test p = 0.19). A logistic regression model showed a significant linear trend for the association between the score and abstinence status after adjustment for possible confounding factors (p = 0.03). The crude incremental cost for one individual to successfully quit smoking due to the support program was ¥46,379 (i.e., ¥100 = $1.28, £0.83, or €1.03 at foreign exchange rates). The corresponding costs for the three categories of the Fagerström Test score for Nicotine Dependence were ¥31,953, ¥47,450 and ¥64,956, respectively. When a sensitivity analysis was conducted based on the 95% confidence interval of the success rate, the variance in the corresponding costs was ¥25,514–45,034 for 0–2 points, ¥38,344–61,824 for 3–6 points, and ¥45,698–108,260 for 7–10 points. The degree of nicotine dependence may therefore be an important determinant of the cost-effectiveness of smoking cessation programs.

Suggested Citation

  • Koshi Nakamura & Masaru Sakurai & Katsuyuki Miura & Yuko Morikawa & Shin-ya Nagasawa & Masao Ishizaki & Teruhiko Kido & Yuchi Naruse & Yasushi Suwazono & Hideaki Nakagawa, 2013. "Nicotine Dependence and Cost-Effectiveness of Individualized Support for Smoking Cessation: Evidence from Practice at a Worksite in Japan," PLOS ONE, Public Library of Science, vol. 8(1), pages 1-9, January.
  • Handle: RePEc:plo:pone00:0055836
    DOI: 10.1371/journal.pone.0055836
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    References listed on IDEAS

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    1. Altman, D.G. & Flora, J.A. & Fortmann, S.P. & Farquhar, J.W., 1987. "The cost-effectiveness of three smoking cessation programs," American Journal of Public Health, American Public Health Association, vol. 77(2), pages 162-165.
    2. Ong, M.K. & Glantz, S.A., 2005. "Free nicotine replacement therapy programs vs implementing smoke-free workplaces: A cost-effectiveness comparison," American Journal of Public Health, American Public Health Association, vol. 95(6), pages 969-975.
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