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AJPH First Look, published online ahead of print May 11, 2005
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June 2005, Vol 95, No. 6 | American Journal of Public Health 969-975
© 2005 American Public Health Association
DOI: 10.2105/AJPH.2004.040667

BUILDING CAPACITY AND EVALUATING STRATEGIES

Free Nicotine Replacement Therapy Programs vs Implementing Smoke-Free Workplaces: A Cost-Effectiveness Comparison

Michael K. Ong, MD, PhD and Stanton A. Glantz, PhD

Michael K. Ong is with the VA Palo Alto Health Care System, Palo Alto, Calif, and the Center for Primary Care and Outcomes Research, Department of Medicine, Stanford University, Stanford, Calif. Stanton A. Glantz is with the Division of Cardiology, Department of Medicine, University of California, San Francisco.

Correspondence: Requests for reprints should be sent to Stanton A. Glantz, PhD, Professor of Medicine, Ste 366 Library, 530 Parnassus, University of California, San Francisco, CA 94143–1390 (e-mail: glantz{at}medicine.ucsf.edu).

We compared the cost-effectiveness of a free nicotine replacement therapy (NRT) program with a statewide smoke-free workplace policy in Minnesota. We conducted 1-year simulations of costs and benefits. The number of individuals who quit smoking and the quality-adjusted life years (QALYs) were the measures of benefits. After 1 year, a NRT program generated 18 500 quitters at a cost of $7020 per quitter ($4440 per QALY), and a smoke-free workplace policy generated 10 400 quitters at a cost of $799 per quitter ($506 per QALY). Smoke-free work-place policies are about 9 times more cost-effective per new nonsmoker than free NRT programs are. Smoke-free workplace policies should be a public health funding priority, even when the primary goal is to promote individual smoking cessation.




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