Proactively offering smokers free treatment to quit smoking is cost-effective

Quitting smoking is difficult and quit attempts are less likely to be successful without treatment. Many smokers want to quit and nearly half make a quit attempt each year, but most do so without the benefit of proven treatments.

Proactive outreach programs directly connect smokers to treatments such as nicotine replacement therapy (NRT) and telephone quit coaching. Clinical trials of proactive outreach have proven they help smokers quit smoking, even those not initially planning to quit, but the costs of these programs need further study.

To learn more about the costs of proactive outreach, University of Minnesota researchers analyzed the Offering Proactive Treatment Intervention (OPT-IN) clinical trial that was conducted with smokers who have public health insurance (e.g., Medicaid) in Minnesota. The analysis used a population perspective in order to help state Medicaid programs decide on high value public health investments. The findings were recently published in the journal Addiction.

The study found:

• one year after starting the program, the population quit rate was 16.5% in the proactive outreach group compared to 12.1% in the usual care group;
• the OPT-IN program costs an average of $84 per participant more than usual care;
• the OPT-IN program costs $4,231 per gained Quality Adjusted Life Year (QALY)—a measure of both the quality and the quantity of life gained by the program. This is far less than the $100,000 to $150,000 per QALY U.S. economists consider as reasonable costs and what the public is typically willing to pay for health care interventions.

"Taken together with prior research, population-level proactive tobacco cessation outreach programs are judged to be highly cost effective over the long term," said the study's principal investigator Steven Fu, M.D., a professor in the Medical School on the Twin Cities campus and a Masonic Cancer Center member. "State Medicaid programs and health systems should consider implementing proactive outreach cessation programs, a high value investment, to enhance engagement in evidence-based smoking cessation treatment and improve population health outcomes."