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Use of nicotine replacement therapies (NRT) is a cost-effective cessation method.

NRT is generally cost-effective for men and women in low-, middle-, and high-income countries. Estimates of the cost-effectiveness of a global policy to make NRT freely available to smokers interested in quitting predict that 1 million smoking-attributable deaths could be averted if this policy resulted in a reduction in smoking prevalence by 0.5 percentage points. Assuming this effectiveness of providing free NRT, generating one Disabbility Ajusted Live Year (DALY) would cost about US$1,917. If providing free NRT would reduce smoking prevalence by 2.5%, five million deaths would be averted at a cost of only US$358 per DALY. The cost per DALY is lower in low- and middle-income countries (US$280–870) compared to high-income countries (US$750–7206).

A study across six high-income Western countries - Canada, France, Spain, Switzerland, the US, and the UK - found that, while the cost-effectiveness of nicotine-replacement therapies (such as nicotine gum, inhaler, patch) varied significantly, the results are favorable compared to common preventive pharmacotherapies which are used for other conditions. Meta-analyses have found the NRT successfully aids cessation in around 6.75% of all smokers, twice the rate of those receiving placebo. This means that about 3% additional smokers quit who would otherwise not have done so.

A systematic review of interventions for preventing cardiovascular disease in low- and middle-income countries found NRT to be cost-effective, but to a lesser degree than population-based tobacco control interventions.

Ranson MK, Jha P, Chaloupka FJ, Nguyen SN. Global and regional estimates of the effectiveness and cost-effectiveness of price increases and other tobacco control policies. Nicotine Tob Res. 2002; 4: 311-319.

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

Cornuz J, Gilbert A, Pinget C, McDonald P, Slama K, Salto E, Paccaud F. Cost-effectiveness of pharmacotherapies for nicotine dependence in primary care settings: a multinational comparison. Tob Control, 2006; 15(3): 152-159.

Laxminarayan R, Chow J, Shahid-Salles SA. Intervention Cost-Effectiveness: Overview of Main Messages. In: Jamison DT, Breman JG, Measham AR, Alleyne G, Claeson M, Evans DB, Jha P, Mills A, Musgrove P, editors. Disease Control Priorities in Developing Countries. 2nd edition. Washington (DC): World Bank; 2006. Chapter 2.

Moore D, Aveyard P, Connock M, Wang D, Fry-Smith A, Barton P. Effectiveness and safety of nicotine replacement therapy assisted reduction to stop smoking: systematic review and meta-analysis. BMJ 2009;338:b1024

Stead LF, Perera R, Bullen C, Mant D, Hartmann-Boyce J, Cahill K, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews. 2012, Issue 11. Art. No.: CD000146.pub4.

Shroufi A, Chowdhury R, Anchala R, Stevens S, Blanco P, Han T, Niessen L, Franco OH. Cost effective interventions for the prevention of cardiovascular disease in low and middle income countries: a systematic review. BMC Public Health. 2013; 13: 285.

Hall SM, Lightwood JM, Humfleet GL, Bostrom A, Reus VI, Muñoz R. Cost-effectiveness of bupropion, nortriptyline, and psychological intervention in smoking cessation. J Behav Health Serv Res. 2005; 32: 381–392.

Shahab L. Cost-effectiveness of pharmacotherapy for smoking cessation. National Centre for Smoking Cessation and Training (NCSCT), 2012. logo
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