Healthcare Costs and Utilization of Smoking and Quitting

每年由烟草相关疾病、残疾和死亡造成的医疗费用和生产力损失造成的成本估计超过1500亿美元。尽管烟草给卫生保健系统带来了明显的经济负担，而且有针对烟草依赖的行之有效的治疗方法，但美国的许多保险计划和健康计划并没有为这些治疗提供全面的好处。健康保险公司和卫生保健系统寻求投资戒烟治疗的“商业案例”。这项研究将为戒烟对吸烟者的医疗保健利用和成本的影响提供新的数据

Annual costs resulting from medical expenses and lost productivity due to tobacco-related disease, disability, and death, areestimated at more than $150 billion. Despite the clear economic burden of tobacco on the health care system and the availability of proven treatments for tobacco dependence, many insurance programs and health plans in the United States do not offer a comprehensive benefit for these treatments. Health insurers and health care systems seek a 'business case' for investment in cessation treatment. This study wilt contribute new data on the impacts of cessation on health care utilization and costs of smokers quitting and not quitting within a large network of primary care clinics. A unique feature of the research is the longitudinal examination of health care utilization and costs for smokers actively recruited during routine primary care visits to receive pharmacotherapy and psychosocial cessation treatment. The specific aims of this study are to: (1) Obtain longitudinal data on health care utilization from the cohort of 1320 smokers participating in the Effectiveness study and from a sample of 633 continuing smokers identified through electronic medical record review who have not been recruited into a treatment-outcome study, (2) Using quit dates of protracted abstainers in the effectiveness study as reference points, compare health care utilization and costs among quitters and continuing smokers in the effectiveness trial cohort for two years prior to cessation and up to three and a half years post-cessation, (3) Using quit dates of protracted abstainers as reference points, compare types of health care visits and diagnoses among quitters and continuing smokers in the effectiveness study, and (4) Using data from the effectiveness study quitters (Cases) and the comparison group of patients who are continuing smokers (Controls), model the health care costs and utilization of quitters against their predicted costs had they not quit as determined from controls.