Economic implications of smoking cessation therapies: a review of economic appraisals.

There is a paucity of studies on the economics of smoking cessation. Those undertaken have investigated only a narrow range of available interventions, using variable methodologies which make interstudy comparisons problematical. There is a need for more economic appraisal in this area and for greater consistency in the methodologies employed. Growing evidence on the effectiveness of pharmacotherapies has not been matched by evidence of their cost effectiveness, and studies in this area, particularly on transdermal nicotine, are urgently required. Cost-benefit analyses (CBAs) have focused on programmes targeted at pregnant women and indicate that resource savings, mainly from reductions in the number of low birthweight neonates, can exceed the costs of the measures. Efforts to persuade pregnant women to quit thus appear to be highly cost beneficial, but further evidence on the efficiency of measures targeted at other groups or to the general population of smokers is required. Cost-effectiveness analyses (CEAs) suggest that measures targeted at specific groups are more cost effective than those targeted at the general population of smokers, and that the cost effectiveness of such programmes is further improved by providing educational materials that are specific to the targeted groups. Advice on how to maintain abstinence appears to improve the cost effectiveness of help with quitting, and routine advice from physicians to their smoking patients is a cost-effective way of reducing smoking prevalence.