Evidence map›Paper›PMID 24329972›Full record

Trial reportAddiction (Abingdon, England)2014

Cost-effectiveness of extended cessation treatment for older smokers.

Paul G Barnett, Wynnie Wong, Abra Jeffers, Ricardo Munoz, Gary Humfleet, Sharon Hall

Abstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Addiction (Abingdon, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Paul G BarnettDepartment of Psychiatry, University of California, San Francisco, San Francisco, CA, USA; Veterans Affairs Health Economics Resource Center, Stanford University, Palo Alto, CA, USA.
Wynnie Wong
Abra Jeffers
Ricardo Munoz
Gary Humfleet
Sharon Hall

Funding

TREATMENTS FOR COMPLEX PATIENTS IN NEW SETTINGSP50DA009253 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI PROCHASKA, JUDITH J. · 1994 to 2014
$28.2M
Maintaining Nonsmoking: Treatment of Older SmokersR01DA002538 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HUMFLEET, GARY L · 1985 to 2013
$5.4M
Treatment of Complex Patients: Emphasis on NicotineK05DA016752 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HALL, SHARON M. · 2003 to 2012
$1.1M
Treating Tobacco Dependence in Inpatient PsychiatryK23DA018691 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI PROCHASKA, JUDITH J. · 2005 to 2009
$769k
NIDA NIH HHS K05 DA016752NIDA NIH HHS K23 DA018691NIDA NIH HHS P50 DA009253NIDA NIH HHS P50 DA 09253NIDA NIH HHS R01 DA002538NIDA NIH HHS R01 DA02538
6 · The paper itself

Abstract

aimsWe examined the cost-effectiveness of extended smoking cessation treatment in older smokers.

designParticipants who completed a 12-week smoking cessation program were factorial randomized to extended cognitive behavioral treatment and extended nicotine replacement therapy.

settingA free-standing smoking cessation clinic.

participantsA total of 402 smokers aged 50 years and older were recruited from the community. MEASUREMENTS: The trial measured biochemically verified abstinence from cigarettes after 2 years and the quantity of smoking cessation services utilized. Trial findings were combined with literature on changes in smoking status and the age- and gender-adjusted effect of smoking on health-care cost, mortality and quality of life over the long term in a Markov model of cost-effectiveness over a lifetime horizon.

findingsThe addition of extended cognitive behavioral therapy added $83 in smoking cessation services cost [P = 0.012, confidence interval (CI) = $22-212]. At the end of follow-up, cigarette abstinence rates were 50.0% with extended cognitive behavioral therapy and 37.2% without this therapy (P < 0.05, odds ratio 1.69, CI 1.18-2.54). The model-based incremental cost-effectiveness ratio was $6324 per quality-adjusted life year (QALY). Probabilistic sensitivity analysis found that the additional $947 in lifetime cost of the intervention had a 95% confidence interval of -$331 to 2081; the 0.15 additional QALYs had a confidence interval of 0.035-0.280, and that the intervention was cost-effective against a $50 000/QALY acceptance criterion in 99.6% of the replicates. Extended nicotine replacement therapy was not cost-effective.

conclusionsAdding extended cognitive behavior therapy to standard cessation treatment was cost-effective. Further intensification of treatment may be warranted.

Indexed as

AgedAged, 80 and overCognitive Behavioral TherapyCost-Benefit AnalysisCounselingFemaleHumansMaleMiddle AgedPatient Acceptance of Health CareQuality-Adjusted Life YearsSecondary PreventionSmoking CessationTobacco Use Cessation DevicesTobacco Use DisorderTreatment OutcomeClinical trialcognitive behaviorial treatmentcost-effectiveness analysisextended smoking cessationincremental cost-effectiveness ratioMarkov modeltobacco use cessation

Identifiers

PMID24329972
PMCPMC4020783

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.