Cost-utility analysis of provision of e-cigarette starter kits for smoking cessation in emergency departments: an economic evaluation of a randomised controlled trial

Li, Jinshou, Wu, Qi, Parrott, Steve, Pope, Ian ORCID: https://orcid.org/0000-0002-5623-4178, Clark, Lucy ORCID: https://orcid.org/0000-0001-7162-0512, Clark, Allan ORCID: https://orcid.org/0000-0003-2965-8941, Ward, Emma ORCID: https://orcid.org/0000-0002-7579-3215, Belderson, Pippa, Stirling, Susan, Coats, Timothy, Bauld, Linda, Holland, Richard, Gentry, Sarah, Agrawal, Sanjay, Bloom, Benjamin, Boyle, Adrian, Gray, Alasdair, Morris, Geraint, Livingstone-Banks, Jonathan and Notley, Caitlin ORCID: https://orcid.org/0000-0003-0876-3304 (2024) Cost-utility analysis of provision of e-cigarette starter kits for smoking cessation in emergency departments: an economic evaluation of a randomised controlled trial. Addiction. ISSN 0965-2140 (In Press)

PDF (COSTED_HEc_paper_accepted) - Accepted Version Restricted to Repository staff only until 31 December 2099. Request a copy

Abstract

Aims: To assess the cost-effectiveness of the Cessation of Smoking Trial in Emergency Department (COSTED) intervention compared with signposting to local stop smoking service (SSS) from the National Health Service (NHS) and personal social services (PSS) perspective. Design: A two-group, multi-centre, pragmatic, individually randomised controlled trial. Setting: Six Emergency Departments (EDs) in urban and rural areas in the UK. Participants: Adult (≥18 years) daily smokers (≥1 cigarette or equivalent per day) but not daily e-cigarette users, with carbon monoxide reading ≥8ppm, attending the ED (n=972). Intervention and comparator: The intervention consisted of provision of an e-cigarette starter kit plus brief smoking cessation advice, and referral to a local SSS. Control was an information card on how to access local SSS. Measurements: Intervention costs included costs of training and delivery. Control costs included costs of printing information cards. Costs of smoking cessation and healthcare services were estimated based on quantities reported by participants and unit costs extracted from secondary sources. The effects were measured by quality-adjusted life years (QALYs) derived from EQ-5D-5L. Other outcomes were smoking cessation measures. The primary outcome was incremental cost-effectiveness ratio (ICER), which was calculated by dividing the difference in costs by the difference in QALYs between groups. Findings: The mean intervention costs were £48 (standard error [SE] £0) per participant and the mean control costs were £0.2 (SE £0) per participant. Using regression estimates, total costs were £31 (95% confidence interval [CI] -£341 to £283) higher and 6-month QALYs were 0.004 (95% CI -0.004 to 0.014) higher in the intervention group than in the control group. The ICER was calculated at £7,750 (probability of cost-effective at range £20,000 - £30,000: 72.2% - 76.5%). Conclusions: The UK Cessation of Smoking Trial in Emergency Department (COSTED) intervention (provision of an e-cigarette starter kit plus brief smoking cessation advice) was cost-effective compared with signposting to local stop smoking services under the current recommendations of the maximum acceptable thresholds.

Item Type:	Article
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit Faculty of Medicine and Health Sciences > Research Centres > Population Health Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Social Sciences > Research Centres > Centre for Research on Children and Families Faculty of Social Sciences > Research Groups > Child Protection & Family Support
Depositing User:	LivePure Connector
Date Deposited:	10 Oct 2024 11:30
Last Modified:	10 Oct 2024 11:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/96979
DOI:	issn:0965-2140

Actions (login required)

View Item