Abstract
BackgroundAlthough evidence exists for the effectiveness of web-based smoking cessation interventions, information about the cost-effectiveness of these interventions is limited.ObjectiveThe study investigated the cost-effectiveness and cost-utility of two web-based computer-tailored (CT) smoking cessation interventions (video- vs. text-based CT) compared to a control condition that received general text-based advice.MethodsIn a randomized controlled trial, respondents were allocated to the video-based condition (N = 670), the text-based condition (N = 708) or the control condition (N = 721). Societal costs, smoking status, and quality-adjusted life years (QALYs; EQ-5D-3L) were assessed at baseline, six-and twelve-month follow-up. The incremental costs per abstinent respondent and per QALYs gained were calculated. To account for uncertainty, bootstrapping techniques and sensitivity analyses were carried out.ResultsNo significant differences were found in the three conditions regarding demographics, baseline values of outcomes and societal costs over the three months prior to baseline. Analyses using prolonged abstinence as outcome measure indicated that from a willingness to pay of €1,500, the video-based intervention was likely to be the most cost-effective treatment, whereas from a willingness to pay of €50,400, the text-based intervention was likely to be the most cost-effective. With regard to cost-utilities, when quality of life was used as outcome measure, the control condition had the highest probability of being the most preferable treatment. Sensitivity analyses yielded comparable results.ConclusionThe video-based CT smoking cessation intervention was the most cost-effective treatment for smoking abstinence after twelve months, varying the willingness to pay per abstinent respondent from €0 up to €80,000. With regard to cost-utility, the control condition seemed to be the most preferable treatment. Probably, more time will be required to assess changes in quality of life. Future studies with longer follow-up periods are needed to investigate whether cost-utility results regarding quality of life may change in the long run.Trial RegistrationNederlands Trial Register NTR3102
Highlights
Web-based smoking cessation interventions have large potential for public health [1,2]
This study showed that a web-based CT smoking cessation intervention seemed to be more cost-effective with regard to smoking abstinence rates assessed after twelve months than the usual smoking cessation care in the general practice setting, taking into account a willingness to pay of J18,000
Design and participants The current economic evaluation study was embedded in a three-group randomized controlled trial (RCT) that tested the effectiveness of two multiple CT smoking cessation interventions against a control condition
Summary
Web-based smoking cessation interventions have large potential for public health [1,2]. Different web-based computer-tailored (CT) smoking cessation interventions have already been developed and implemented to aid people to quit smoking [1,4,5]. Even though evidence exists for the effectiveness of web-based CT smoking cessation interventions [1,5,8], they often have difficulty attracting and holding respondents [10,11,12]. Since websites increasingly make use of new web-based technologies like videos or pictures, simple text messages may no longer be attractive enough for current Internet users. Since video-based messages seem to require less mental effort and may help the person to concentrate on the core elements of the message [15], the integration of video messages may increase the appeal and potentially the (cost-)effectiveness of webbased CT smoking cessation interventions. Evidence exists for the effectiveness of web-based smoking cessation interventions, information about the cost-effectiveness of these interventions is limited
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