Economic evaluation of smoking cessation in Ontario's regional cancer programs
Abstract Quitting smoking after a diagnosis of cancer results in greater response to treatment and decreased risk of disease recurrence and second primary cancers. The objective of this study was to evaluate the potential cost‐effectiveness of two smoking cessation approaches: the current basic smok...
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| Format: | Article |
| Language: | English |
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Wiley
2018-09-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.1495 |
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| author | Sandjar Djalalov Lisa Masucci Wanrudee Isaranuwatchai William Evans Alice Peter Rebecca Truscott Erin Cameron Nicole Mittmann Linda Rabeneck Kelvin Chan Jeffrey S. Hoch |
| author_facet | Sandjar Djalalov Lisa Masucci Wanrudee Isaranuwatchai William Evans Alice Peter Rebecca Truscott Erin Cameron Nicole Mittmann Linda Rabeneck Kelvin Chan Jeffrey S. Hoch |
| author_sort | Sandjar Djalalov |
| collection | DOAJ |
| description | Abstract Quitting smoking after a diagnosis of cancer results in greater response to treatment and decreased risk of disease recurrence and second primary cancers. The objective of this study was to evaluate the potential cost‐effectiveness of two smoking cessation approaches: the current basic smoking cessation program consisting of screening for tobacco use, advice, and referral; and a best practice smoking cessation program that includes the current basic program with the addition of pharmacological therapy, counseling, and follow‐up. A Markov model was constructed that followed 65‐year‐old smokers with cancer over a lifetime horizon. Transition probabilities and mortality estimates were obtained from the published literature. Costs were obtained from standard costing sources in Ontario and reports. Probabilistic and deterministic sensitivity analyses were conducted to address parameter uncertainties. For smokers with cancer, the best practice smoking cessation program was more effective and more costly than the basic smoking cessation program. The incremental cost‐effectiveness ratio of the best practice smoking cessation program compared to the basic smoking cessation program was $3367 per QALY gained and $5050 per LY gained for males, and $2050 per QALY gained and $4100 per LY gained for females. Results were most sensitive to the hazard ratio of mortality for former and current smokers, the probability of quitting smoking through participation in the program and smoking‐attributable costs. The study results suggested that a best practice smoking cessation program could be a cost‐effective option. These findings can support and guide implementation of smoking cessation programs. |
| format | Article |
| id | doaj-art-81c7bfa271364e5fb0565604e3af02ad |
| institution | OA Journals |
| issn | 2045-7634 |
| language | English |
| publishDate | 2018-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-81c7bfa271364e5fb0565604e3af02ad2025-08-20T01:51:39ZengWileyCancer Medicine2045-76342018-09-01794765477210.1002/cam4.1495Economic evaluation of smoking cessation in Ontario's regional cancer programsSandjar Djalalov0Lisa Masucci1Wanrudee Isaranuwatchai2William Evans3Alice Peter4Rebecca Truscott5Erin Cameron6Nicole Mittmann7Linda Rabeneck8Kelvin Chan9Jeffrey S. Hoch10Health Quality Ontario Toronto Ontario CanadaSt. Michael's Hospital Toronto Ontario CanadaSt. Michael's Hospital Toronto Ontario CanadaCancer Care Ontario Toronto Ontario CanadaCancer Care Ontario Toronto Ontario CanadaCancer Care Ontario Toronto Ontario CanadaCancer Care Ontario Toronto Ontario CanadaCancer Care Ontario Toronto Ontario CanadaCancer Care Ontario Toronto Ontario CanadaCancer Care Ontario Toronto Ontario CanadaSt. Michael's Hospital Toronto Ontario CanadaAbstract Quitting smoking after a diagnosis of cancer results in greater response to treatment and decreased risk of disease recurrence and second primary cancers. The objective of this study was to evaluate the potential cost‐effectiveness of two smoking cessation approaches: the current basic smoking cessation program consisting of screening for tobacco use, advice, and referral; and a best practice smoking cessation program that includes the current basic program with the addition of pharmacological therapy, counseling, and follow‐up. A Markov model was constructed that followed 65‐year‐old smokers with cancer over a lifetime horizon. Transition probabilities and mortality estimates were obtained from the published literature. Costs were obtained from standard costing sources in Ontario and reports. Probabilistic and deterministic sensitivity analyses were conducted to address parameter uncertainties. For smokers with cancer, the best practice smoking cessation program was more effective and more costly than the basic smoking cessation program. The incremental cost‐effectiveness ratio of the best practice smoking cessation program compared to the basic smoking cessation program was $3367 per QALY gained and $5050 per LY gained for males, and $2050 per QALY gained and $4100 per LY gained for females. Results were most sensitive to the hazard ratio of mortality for former and current smokers, the probability of quitting smoking through participation in the program and smoking‐attributable costs. The study results suggested that a best practice smoking cessation program could be a cost‐effective option. These findings can support and guide implementation of smoking cessation programs.https://doi.org/10.1002/cam4.1495Cost‐effectivenessoncologysmoking cessation |
| spellingShingle | Sandjar Djalalov Lisa Masucci Wanrudee Isaranuwatchai William Evans Alice Peter Rebecca Truscott Erin Cameron Nicole Mittmann Linda Rabeneck Kelvin Chan Jeffrey S. Hoch Economic evaluation of smoking cessation in Ontario's regional cancer programs Cancer Medicine Cost‐effectiveness oncology smoking cessation |
| title | Economic evaluation of smoking cessation in Ontario's regional cancer programs |
| title_full | Economic evaluation of smoking cessation in Ontario's regional cancer programs |
| title_fullStr | Economic evaluation of smoking cessation in Ontario's regional cancer programs |
| title_full_unstemmed | Economic evaluation of smoking cessation in Ontario's regional cancer programs |
| title_short | Economic evaluation of smoking cessation in Ontario's regional cancer programs |
| title_sort | economic evaluation of smoking cessation in ontario s regional cancer programs |
| topic | Cost‐effectiveness oncology smoking cessation |
| url | https://doi.org/10.1002/cam4.1495 |
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