Nicotine Dependence and Cost-Effectiveness of Individualized Support for Smoking Cessation: Evidence from Practice at a Worksite in Japan
Nicotine Dependence and Cost-Effectiveness of Individualized Support for Smoking Cessation: Evidence from Practice at a Worksite in Japan
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DOI：
10.1371/journal.pone.0055836
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发表时间：
2013-01-30
期刊：
影响因子：
3.7
通讯作者：
Nakagawa, Hideaki
中科院分区：
文献类型：
--
作者：
Nakamura, Koshi;Sakurai, Masaru;Nakagawa, Hideaki
鉴于缺乏从项目发起人的角度评估戒烟计划效果的经济学研究，我们进行了一项案例研究，为工作场所提供相关信息。本研究于2006年至2008年在日本富山县的一家制造工厂进行，研究对象包括自愿参加戒烟计划的受试者。该计划包括面对面的咨询，然后每周联系一次，在六个月内使用电子邮件或办公室间邮件提供鼓励。如果需要，可以提供尼古丁贴片。所有151名参与者立即停止吸烟。在24个月的研究期间，自我报告显示49.7%的人持续戒烟。尼古丁依赖的Fagerstrom测试得分较低的参与者的24个月连续戒烟率高于那些得分较高的参与者(0-2分的63.6%，3-6分的46.5%，7-10分的43.8%；卡方检验p=0.19)。Logistic回归模型显示，在调整可能的混杂因素后，得分与戒酒状况之间的关联呈显著的线性趋势(p=0.03)。由于支持计划，一个人成功戒烟的粗略增量成本为46,379(即(原文如此)100=1.28美元，0.83英镑，或(原文如此)1.03(按汇率计算))。尼古丁依赖的Fagerstrom测试评分的三个类别的相应成本分别为31,953，47,450和64,956。当根据成功率的95%可信区间进行敏感性分析时，0-2分对应成本的方差为25,514-45,034，3-6分对应成本的方差为38,344-61,824，7-10分对应成本的方差为45,698-108,260。因此，尼古丁依赖程度可能是戒烟计划成本效益的重要决定因素。
Given the lack of economic studies evaluating the outcomes of smoking cessation programs from the viewpoint of program sponsors, we conducted a case study to provide relevant information for worksites. The present study was carried out between 2006 and 2008 at a manufacturing factory in the Toyama Prefecture of Japan and included subjects who voluntarily entered a smoking cessation program. The program included face-to-face counselling followed by weekly contact to provide encouragement over six months using e-mail or inter-office mail. Nicotine patches were available if required. All 151 participants stopped smoking immediately. Over the 24-month study period, self-report showed 49.7% abstained continuously from smoking. The rate of 24-month consecutive abstinence was higher in participants with lower Fagerstrom Test scores for Nicotine Dependence at baseline than in those with higher scores (63.6% for 0-2 points vs. 46.5% for 3-6 points vs. 43.8% for 7-10 points; chi-square test p = 0.19). A logistic regression model showed a significant linear trend for the association between the score and abstinence status after adjustment for possible confounding factors (p = 0.03). The crude incremental cost for one individual to successfully quit smoking due to the support program was 46,379 (i.e., (sic)100 = $1.28, 0.83 pound, or (sic)1.03 at foreign exchange rates). The corresponding costs for the three categories of the Fagerstrom Test score for Nicotine Dependence were (sic)31,953, (sic)47,450 and 64,956, respectively. When a sensitivity analysis was conducted based on the 95% confidence interval of the success rate, the variance in the corresponding costs was (sic)25,514-45,034 for 0-2 points, (sic)38,344-61,824 for 3-6 points, and (sic)45,698-108,260 for 7-10 points. The degree of nicotine dependence may therefore be an important determinant of the cost-effectiveness of smoking cessation programs.