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A smoking cessation counsellor: should every hospital have one?

Department Llandough Hospital Penarth, Nr. Cardiff South Wales CF64 2XX

Sonja Tjeder

Department Llandough Hospital Penarth, Nr. Cardiff South Wales CF64 2XX

Ceri Phillips, BSc(Econ), MSc (Econ), PhD

University of Wales, Swansea Singleton Park Swansea SA2 8PP

Ian A. Campbell, MD, FRCP

Department Llandough Hospital Penarth, Nr. Cardiff South Wales CF64 2XX

The study was performed in order to ascertain the sustained smoking cessation rate in hos pital patients who received a structured programme of advice and support from a counsel lor and to estimate the cost-effectiveness of such an intervention. Hospital in-patients and out-patients were referred by their physician/surgeon to the smoking cessation counsellor who provided advice to reinforce that of the doctor and gave support by repeated follow-up sessions, weekly in the first month and thereafter at three, six and twelve months. Of 1,155 patients referred to the counsellor, 114 (13%) failed to keep the first appointment and 348 (30%) attended for advice on one occasion only. Among the latter, the self-reported sus tained cessation rate at one year was 5%. In the 663 patients who participated in the pro gramme the validated (expired air CO) 12-month, sustained cessation rate was 21%. Allowing 7.5% success rate among patients receiving a physician's advice only, the cost of each additional success achieved as a result of the programme is £851 and the cost per life year saved is between £340 and £426. Assuming that after one year's abstinence relapse rates are relatively small, this represents a sound investment in the light of the cost of treating patients with smoking-related illnesses and compares favourably with other smoking cessa tion strategies and health care interventions.

Key Words: Counsellor • cost-effectiveness • hospital patients • smoking cessation • structured programme

The Journal of the Royal Society for the Promotion of Health, Vol. 118, No. 6, 356-359 (1998)
DOI: 10.1177/146642409811800614


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