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Policies that promote smoking cessation are highly cost-effective, and are more cost-effective than many other public health interventions.

The costs per life year saved by smoking cessation interventions and policies leading to reduced tobacco use are small compared to other health care interventions. The cost-effectiveness of smoking cessation has been well established by many peer-reviewed studies. An intervention is termed to be very cost effective if the intervention averts one disability-adjusted life year for a value less than a country’s annual per capita GDP.

Higher taxes leading to 33% price increases in low- and middle-income countries would cost just US$23 per averted disability-adjusted life year. Non-price interventions including wider access to NRT are also cost-effective measures, averaging US$396 per disability-adjusted life year averted in low- and middle-income countries. Combining tax increases with other tobacco control measures is more cost-effective than implementing them in isolation.

Smoking cessation interventions are cost-effective relative to other public health interventions like anti-retroviral therapy provided to fight HIV/AIDS which costs US$922 per disability-adjusted life year averted. Both pharmacological and behavioral therapies for smoking cessation are cost-effective or even cost saving. Generally, the less resource-intensive interventions (e.g. self-help materials) are more cost-effective than more resource-intensive interventions (e.g. NRT). The return on investment to smoking cessation programs in the US varies from $0.86 to $2.52 per dollar depending upon the type of intervention.

Despite this evidence, the cost of cessation assistance is not covered in the vast majority of low- and middle-income countries, and in 2012, only 15% of the world’s population, living in 21 countries are covered by a cessation policy that the World Health Organization calls ‘complete’.

Krumholz HM, Weintraub WS, Bradford WD, Heidenreich PA, Mark DB, Paltiel AD. Task force #2--the cost of prevention: can we afford it? Can we afford not to do it? 33rd Bethesda Conference. J Am Coll Cardiol. 2002; 40(4): 603-615.

Ranson MK, Jha P, Chaloupka FJ, Nguyen SN. The effectiveness and cost-effectiveness of price increases and other tobacco control policies. In Jha P, Chaloupka FJ, eds. Tobacco control in developing countries, 2000; pp.427-447 (Section V, Chapter 18).

Godfrey C, Parrott S
. Cost effectiveness of smoking cessation interventions. In: Syrigos NK, Nutting CM, Roussos C (eds). Tumors of the Chest: Biology, Diagnosis, and Treatment. Springer Berlin Heidelberg 2006, pp641-648

World Bank. World Development Report 1993: Investing in Health.

Novotny TE, Cohen JC, Yurekli A, Sweanor S, de Beyer J. Smoking cessation and nicotine-replacement therapies . In Jha P, Chaloupka FJ Tobacco Control in Developing Countries, Section III, Chapter 12, 2000.

Rasmussen SR, Prescott E, Sørensen TIA, Søgaard J. The total lifetime health cost savings of smoking cessation to society. Eur J Public Health. 2005; 15(6): 601-606.

Lazar CM, Ruger JP. Economic Evaluation of Pharmaco- and Behavioral Therapies for Smoking Cessation: A Critical and Systematic Review of Empirical Research. Annual Review of Public Health, 2012; 33: 279-305.

Rumberger JS, Hollenbeak CS, Kline D
. Potential Costs and Benefits of Smoking Cessation in the United States. Penn State, April 30, 2010.

WHO Report on the Global Tobacco Epidemic, 2013: Enforcing bans on tobacco advertising, promotion and sponsorship. World Health Organization: Geneva.

Chisolm D, Abegunde D, Mendis S. Scaling up Action against Noncommunicable Diseases: How Much Will It Cost? Geneva: World Health Organization, 2011. logo
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