Cost-effectiveness of a nurse-delivered, inpatient smoking cessation intervention

Charlotte E. Ward*, Stephanie V. Hall, Paul G. Barnett, Neil Jordan, Sonia A. Duffy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Randomized controlled trials have shown that inpatient tobacco cessation interventions are highly efficacious and cost-effective. However, the degree to which smoking interventions implemented in nonrandomized, real-world practice settings are effective, and consequently, cost-effective, remains unclear. This study evaluated the cost-effectiveness of a nurse-delivered, inpatient smoking cessation intervention, Tobacco Tactics, compared with usual care within the context of an observational, real-world study design. In this quasi-experimental study, five Michigan hospitals (N = 1,370 patients) were assigned to implement either Tobacco Tactics or usual care during October 2011-May 2013. Statistical analysis was conducted during January 2017-February 2018. Controlling for confounding using stabilized inverse probability of treatment weights, incremental cost-effectiveness ratios were calculated and cost-effectiveness acceptability curves were generated. The per person cost of tobacco cessation services in the intervention group exceeded that of usual care ($175.52 vs. $67.80; p <. 001). The intervention group had a higher propensity-adjusted self-reported quit rate compared to the control group (15.7% vs. 7.0%; p <. 0001). The propensity-adjusted incremental cost-effectiveness ratio was $1,325 per quit (95% confidence interval: $751-$2,462), with 99.9% probability of being cost-effective at a willingness to pay of $5,000 per quit. The Tobacco Tactics intervention was found to be cost-effective and well within the range of incremental cost-per-quit findings from other studies of tobacco cessation interventions, which range from $918 to $23,200, adjusted for inflation.

Original languageEnglish (US)
Pages (from-to)1481-1490
Number of pages10
JournalTranslational behavioral medicine
Issue number6
StatePublished - Dec 1 2020


  • Cost-effectiveness
  • Intervention
  • Prevention
  • Quasi-experimental design
  • Tobacco cessation

ASJC Scopus subject areas

  • Applied Psychology
  • Behavioral Neuroscience


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