The cost effectiveness of telephone counselling to aid smoking cessation in Denmark: A modelling study

Aim: To assess the cost-effectiveness of the Danish smoking cessation telephone service “quitline”. Methods: The study was based on the number of quitline callers in 2005. The outcome was measured as costs per life year saved (LYS) based on the assessment in 2001 of continued abstinence over a 12-month period (19.0%) and point prevalence of abstinence at 12 months of follow up (29.7%), respectively. The costs per LYS are estimated as the annual running costs of reactive telephone counselling service divided by the total number of LYS, which has been estimated as the difference between current smokers’ and ex-smokers’ life expectancies according to age group and gender based on Danish smoking proportions, relative risks of smoking-related mortality of all causes, and standard life tables. Results: A total of 511 ex-smokers have been estimated to gain 2172 life years based on continued abstinence over 12 months. Using the point prevalence abstinence at 12 months, 799 ex-smokers are estimated to gain 3394 life years. Discounting LYS at 3% p.a., the costs per LYS are €213 for ex-smokers with continued abstinence and €137 for ex-smokers with point prevalence abstinence. The sensitivity analysis for a worst-case scenario indicates that the costs per LYS are €1199. For comparison the average costs per LYS of smoking cessation interventions in other Danish settings are €1592 (95% CI €1547-1636). Conclusions: The Danish reactive telephone counselling to aid smoking cessation appears to be cost-effective in comparison with other Danish smoking cessation interventions.