Cost-benefit analysis of funding a smoking cessation program before surgery

For patients undergoing surgery, smoking is linked with a higher risk of experiencing complications following their procedure, and quitting smoking before surgery may help reduce this risk. A new BJS (formerly British Journal of Surgery) study examined whether a smoking cessation intervention before surgery is economically worthwhile when funded by the National Health System (NHS) in Spain.

The intervention was a combination of medical counselling and use of a smoking cessation drug 12 weeks before surgery, and the benefits were the costs avoided by averting postoperative complications if cessation was successful.

When investigators compared the net economic outcome (benefit minus cost of the intervention) and the return on investment for the intervention funded by the NHS versus the current situation without funding, they found that the benefit of funding the programme greatly outweighs the costs.

Smoking cessation increased by 21.7% with funding. The cost per averted smoker was €1,753 with a net benefit of €503. Given the annual cost of the intervention, the return on investment was 28.7%, equivalent to €1.29 per €1 of investment.

"There is no published study, as far as we can find, about the efficiency of health programmes or policies aimed at smoking cessation prior to planned surgery with hospitalization. Thus, this work is unique," said senior author Javier Rejas, MD, Ph.D., of Pfizer SLU, in Spain.