Affiliation:
1. School of Pharmacy
2. Faculty of Medicine, Memorial University, St. John’s, NL
3. School of Nursing
Abstract
Background: Tobacco use is the leading preventable cause of morbidity and mortality in Canada. Smoking cessation programs (SCPs) that are effective, cost-effective and widely available are needed to help smokers quit. Pharmacists are uniquely positioned to provide such services. This study compares the abstinence rates between 2 pharmacist-led SCPs and the cost-effectiveness between these and a comparator group. The study was conducted in St. John’s, Newfoundland and Labrador. Methods: This pragmatic, mixed-method trial randomized smokers to either an existing intensive SCP or a new abbreviated SCP designed for community pharmacies. The primary outcome was 6-month abstinence rates. Cost-effectiveness was determined using abstinence rates for the SCPs and a comparator group. Incremental costs per additional quit were calculated for the trial duration, and incremental costs per life-year gained were estimated over a lifetime. Results: Quit rates for the SCPs were 36% (intensive) and 22% (abbreviated) ( p = 0.199). Incremental costs per life-year gained for the SCPs were $1576 (intensive) and $1836 (abbreviated). The incremental costs per additional quit, relative to the comparator group, for the SCPs were $1217 (intensive) and $1420 (abbreviated). Discussion: Both SCPs helped smokers quit, and quit rates exceeded those reported for a comparator group that included a general population of adult smokers (~7%). The incremental costs per additional quit for both SCPs compare favourably to those reported for other initiatives such as quit lines and hospital-based interventions. Conclusion: Pharmacist-led smoking cessation programs are effective and highly cost-effective. Widespread implementation, facilitated by remuneration, has potential to lower smoking prevalence and associated costs and harms.
Subject
Pharmaceutical Science,Pharmacy
Reference58 articles.
1. World Health Organization. Tobacco facts. Available: https://www.who.int/news-room/fact-sheets/detail/tobacco (accessed Feb. 18, 2021).
2. Centers for Disease Control and Prevention. Health effects of smoking and tobacco use. Available: https://www.cdc.gov/tobacco/basic_information/health_effects/index.htm#:~:text=Smoking%20causes%20cancer%2C%20heart%20disease,immune%20system%2C%20including%20rheumatoid%20arthritis (accessed Feb. 18, 2021).
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