Two interventions to help smokers quit - when less is more

Abstract

Abstract Smoking cessation has known individual health benefits and significant positive economic effect at the population level. Interventions aiming to help smokers quit are available in most EU countries, involving individual or group-work and pharmacotherapy. Public health resources are limited and insufficient. Research, comparing different approaches taking into account necessary resources, is needed to select the most effective interventions. Since 2008 in Pozega-Slavonia County, Croatia, there have been two organized programs, without pharmacotherapy, for smokers. Namely: “Non-smoking school” as an intensive group-work and the “Quit and win” based contest combined with individual support. We compared the two approaches, measured as costs for human and material resources. The aim was to determine which approach costs less for the same outcome defined as one long term (6 months) successful ex-smoker. There were 63 smokers in the group program. The 30 day abstinence rate was 77.8% (49/63), and out of those 38.8% (19/49) abstained long term. Follow up rate was 100%. Group-work cost was €10,702/63 smokers; €170 per smoker, €218 for a short term and €563 for a long term ex-smoker. Human resources cost were 96.5% of the resources. There were 153 smokers in the contest. Short term abstinence rate was 73.9% (113/153) and out of those 34.1% (31/91) abstained long term. Follow up rate was 80.5%. Contest cost was €11,292/153 smokers; €74 per smoker, €100 for a short term and €364 for a long term ex-smoker. Human resources cost were 45.2% of the resources. In the contest, equivalent long term abstinence rates were achieved for only 64.7% of resources and 50% less human resources (96.5% vs. 45.2% human resources in all resources) compared to group therapy program. Novel combination of evidence-based approaches “Quit and win” with individual support shows promising results using less human and material resources delivering results comparable to costlier intensive group-work. Key messages We have shown that an extra financial spending significantly reduces work-load resulting in lower cost per ex-smoker. Contests could be used as a successful method to help smokers quit, using the same limited resources available.