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Cost effectiveness of tobacco control measures in England
Lesley Owen, Technical Adviser, National Institute for Health and Clinical Excellence, London, UK
Abstract
The Centre for Public Health Excellence at the National Institute for Health and Clinical Excellence (NICE) is responsible for proving guidance on the promotion of good health and the prevention of ill health in England. Since 2005 NICE has produced five guidance documents on tobacco and has two currently in development.
Methods
Health economic analysis and evaluation forms an integral part of the guidance development process, as the committees developing the guidance have to make their decisions based on both the effectiveness and cost effectiveness of interventions.
NICE uses the cost per quality adjusted life year (cost/QALY) to assess the cost-effectiveness of an intervention. The QALY is a measure that combines how much someone’s life can be extended and improved by an intervention. NICE uses the threshold of £20 to £30k as the ‘value’ the NHS is prepared to pay for an intervention.
Results
The cost per quality-adjusted life year (QALY) of smoking cessation interventions is generally low or very low. For example, the cost of brief advice (five minutes) from a GP combined with nicotine replacement therapy yielded a cost per QALY in the range £1,666 to £4,833 compared with the NICE threshold of about £20,000 to £30,000.
Conclusions
The results suggest that programmes to support smoking cessation are highly cost effective.
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