TY - JOUR
T1 - Motivational interviewing to encourage quit attempts among smokers not ready to quit
T2 - A trial-based economic analysis
AU - Rasu, Rafia S.
AU - Thelen, Joanie
AU - Agbor Bawa, Walter
AU - Goggin, Kathy
AU - Bradley-Ewing, Andrea
AU - Catley, Delwyn
N1 - Funding Information:
This study was supported by a grant (R01 CA133068) from National Institutes of Health (NIH), National Cancer Institute (PI, DC). Pfizer provided varenicline (Chantix) through Investigator-Initiated Research Support (No. WS759405). This study "A Trail-Based Economic Evaluation of Clinical Interventions to Motivate Smokers to Quit" was also funded by Frontier Trail Blazer Award (PI, RR), The Heartland Institute for Clinical and Translational Research. This project was supported by an Institutional Clinical and Translational Science Award, NIH/National Center for Advancing Translational Science grant number 8UL1TR000001-02.
Publisher Copyright:
© 2019 The Author(s) 2019.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Introduction: This study used data from a randomized controlled trial evaluating the efficacy of motivational interviewing (MI) relative to health education (HE) and brief advice (BA) to encourage quit attempts and cessation in order to determine their relative cost-effectiveness. Aims and Methods: Urban community residents (n = 255) with low desire to quit smoking were randomized to MI, HE, or BA which differed in communication style and/or number of treatment sessions. Incremental cost-effectiveness ratios were used to compare the intensive interventions (MI and HE) to BA for facilitating quit attempts and smoking cessation. Costs were calculated from the perspective of an agency that might engage in program delivery. Sensitivity analysis examined different assumptions for MI training and pharmacotherapy costs. Results: Total intervention delivery time costs per participant for MI, HE, and BA were $46.63, $42.87, and $2.4, respectively. Cost-effectiveness ratios per quit attempt at 24 weeks were $380 for MI, $272 for HE, and $209 for BA. The cost per additional quit attempt for MI and HE relative to BA was $508 and $301, respectively. The cost per additional quit for MI and HE relative to BA was $2030 and $752, respectively. Four separate sensitivity analyses conducted in our study did not change the conclusion the HE had a lower Incremental Cost-Effectiveness Ratio for both quit attempts and cessation. Conclusions: HE was the most cost-effective of the three types of smoking cessation induction therapies and therefore may be preferable for smokers who are less motivated to quit. Providing valuable cost information in choosing different clinical methods for motivating smokers to quit. Implications: All direct costs and activity-based time costs associated with delivering the intervention were analyzed from the perspective of an agency that may wish to replicate these strategies. A randomized controlled trial evaluating the efficacy of MI relative to HE and BA to encourage quit attempts and cessation determined their relative cost-effectiveness. HE was the most cost-effective of the three types of smoking cessation induction therapies and therefore may be preferable. Despite guideline recommendations, MI may not be the best approach to encourage quit attempts in diverse populations. Rather, a structured, intensive HE intervention might be the most cost-effective alternative.
AB - Introduction: This study used data from a randomized controlled trial evaluating the efficacy of motivational interviewing (MI) relative to health education (HE) and brief advice (BA) to encourage quit attempts and cessation in order to determine their relative cost-effectiveness. Aims and Methods: Urban community residents (n = 255) with low desire to quit smoking were randomized to MI, HE, or BA which differed in communication style and/or number of treatment sessions. Incremental cost-effectiveness ratios were used to compare the intensive interventions (MI and HE) to BA for facilitating quit attempts and smoking cessation. Costs were calculated from the perspective of an agency that might engage in program delivery. Sensitivity analysis examined different assumptions for MI training and pharmacotherapy costs. Results: Total intervention delivery time costs per participant for MI, HE, and BA were $46.63, $42.87, and $2.4, respectively. Cost-effectiveness ratios per quit attempt at 24 weeks were $380 for MI, $272 for HE, and $209 for BA. The cost per additional quit attempt for MI and HE relative to BA was $508 and $301, respectively. The cost per additional quit for MI and HE relative to BA was $2030 and $752, respectively. Four separate sensitivity analyses conducted in our study did not change the conclusion the HE had a lower Incremental Cost-Effectiveness Ratio for both quit attempts and cessation. Conclusions: HE was the most cost-effective of the three types of smoking cessation induction therapies and therefore may be preferable for smokers who are less motivated to quit. Providing valuable cost information in choosing different clinical methods for motivating smokers to quit. Implications: All direct costs and activity-based time costs associated with delivering the intervention were analyzed from the perspective of an agency that may wish to replicate these strategies. A randomized controlled trial evaluating the efficacy of MI relative to HE and BA to encourage quit attempts and cessation determined their relative cost-effectiveness. HE was the most cost-effective of the three types of smoking cessation induction therapies and therefore may be preferable. Despite guideline recommendations, MI may not be the best approach to encourage quit attempts in diverse populations. Rather, a structured, intensive HE intervention might be the most cost-effective alternative.
UR - http://www.scopus.com/inward/record.url?scp=85089819370&partnerID=8YFLogxK
U2 - 10.1093/ntr/ntz228
DO - 10.1093/ntr/ntz228
M3 - Article
C2 - 31820002
AN - SCOPUS:85089819370
SN - 1462-2203
VL - 22
SP - 1515
EP - 1523
JO - Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
JF - Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
IS - 9
ER -