Magazine article Clinical Psychiatry News

Smoking Cessation Intervention for Inpatients Pays Off

Magazine article Clinical Psychiatry News

Smoking Cessation Intervention for Inpatients Pays Off

Article excerpt

CHICAGO -- An intensive smoking cessation intervention that starts while patients are hospitalized for an acute cardiac event is not merely highly cost effective, it is actually cost saving, Robyn Kondrack, Pharm.D., reported at the annual meeting of the American College of Cardiology.

Indeed, the mean cost-effectiveness ratio of providing a 3-month intensive smoking cessation intervention (SCI) to hospitalized smokers in a 209-patient randomized controlled trial was $1,443 per year of life gained, according to Dr. Kondrack of Creighton University, Omaha, Neb.

The total direct cost of medical care during 5 years of prospective follow-up in the SCI arm of the study was $872,376, including nearly $250,000 for the smoking cessation program itself, compared with $1,025,000 in patients randomized to usual care. The major driver of the more than $150,000 in cost savings in the SCI group was their reduced hospital costs over the 5-year period, she said.

Dr. Kondrack's cost analysis was a follow-up to last year's initial report on the Creighton University randomized trial, which showed a 2-year all-cause mortality of 2.8% in the in- tensive SCI group compared with 12.0% in the usual care controls, a 77% relative risk reduction. Twenty-five patients in the SCI group were hospitalized during the first 2 years of follow-up, as were 41 controls, for a 44% relative risk reduction (Chest 2007;131:446-52).

The investigators noted that although the 16 prior randomized controlled trials of SCIs in hospitalized smokers published since 1985 had clearly established that such programs result in higher smoking abstinence rates than usual care, theirs was the first study to demonstrate reduced morbidity and mortality in response to an SCI.

All participants in the Nebraska study were smokers hospitalized in a coronary care unit for an acute cardiac syndrome or acute decompensated heart failure. …

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