{
  "abstract": "Introduction Integrating smoking cessation supports into lung cancer screening can improve abstinence rates. However, healthcare decision-makers need evidence of cost-effectiveness to understand the cost/benefit of adopting this approach.Methods To evaluate the cost-effectiveness of smoking cessation interventions, and service delivery, we used a cohort-based Markov model, adapted from previous National Institute for Health and Care Excellence (NICE) guidelines on smoking cessation. This uses long-term epidemiological data to capture the prevalence of the smoking-related illnesses, updated through targeted literature searches as required from the core NICE model, with costs extracted from publicly recognised UK sources.Results All smoking cessation interventions appeared cost-effective at a threshold of £20 000 per quality-adjusted life year, compared with no intervention or behavioural support alone. Offering immediate smoking cessation as part of lung cancer screening appointments, compared with usual care (onward referral to stop smoking services), was also estimated to be cost-effective with a net monetary benefit of £2198 per person, and a saving of between £34 and £79 per person in reduced workplace absenteeism among working age attendees. Estimated healthcare cost savings were more than four times greater in the most deprived quintile compared with the least deprived, alongside a fivefold increase in quality adjusted life years accrued.Conclusions Smoking cessation interventions within lung cancer screening are cost-effective and should be integrated, so that treatment is initiated during screening visits. This is likely to reduce overall costs to the health service, and wider integrated care systems, improve quality and length of life, and may lessen health inequalities.",
  "authors": [
    {
      "affiliations": [
        "Lung Cancer & Thoracic Surgery Directorate, Manchester University NHS Foundation Trust, Manchester, UK",
        "Manchester Academic Health Science Centre (MAHSC), Faculty of Biology, Medicien & Health, University of Manchester, Manchester, UK"
      ],
      "name": "Matthew Evison"
    },
    {
      "affiliations": [
        "Enterprise House, Innovation Way, York Health Economics Consortium, York, UK"
      ],
      "name": "Rebecca Naylor"
    },
    {
      "affiliations": [
        "Enterprise House, Innovation Way, York Health Economics Consortium, York, UK"
      ],
      "name": "Robert Malcolm"
    },
    {
      "affiliations": [
        "Enterprise House, Innovation Way, York Health Economics Consortium, York, UK"
      ],
      "name": "Hayden Holmes"
    },
    {
      "affiliations": [
        "Enterprise House, Innovation Way, York Health Economics Consortium, York, UK"
      ],
      "name": "Matthew Taylor"
    },
    {
      "affiliations": [
        "UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, UK"
      ],
      "name": "Rachael L Murray"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK"
      ],
      "name": "Matthew EJ Callister"
    },
    {
      "affiliations": [
        "Imperial College London, National Heart and Lung Institute, London, UK"
      ],
      "name": "Nicholas S Hopkinson"
    },
    {
      "affiliations": [
        "Respiratory Medicine, Institute for Lung Health, Department of Respiratory Medicine, Glenfield Hospital, Leicester, UK"
      ],
      "name": "Sanjay Agrawal"
    },
    {
      "affiliations": [
        "Action on Smoking and Health, London, UK"
      ],
      "name": "Hazel Cheeseman"
    },
    {
      "affiliations": [
        "University of Nottingham, Nottingham, UK"
      ],
      "name": "David Baldwin"
    },
    {
      "affiliations": [
        "Lung Cancer & Thoracic Surgery Directorate, Manchester University NHS Foundation Trust, Manchester, UK"
      ],
      "name": "Zoe Merchant"
    },
    {
      "affiliations": [
        "Lung Cancer & Thoracic Surgery Directorate, Manchester University NHS Foundation Trust, Manchester, UK",
        "Division of Immunology, Immunity to Infection and Respiratory Medicine, The University of Manchester Faculty of Biology Medicine and Health, Manchester, UK"
      ],
      "name": "Patrick Goodley"
    },
    {
      "affiliations": [
        "Lung Cancer & Thoracic Surgery Directorate, Manchester University NHS Foundation Trust, Manchester, UK"
      ],
      "name": "Alaa Alsaaty"
    },
    {
      "affiliations": [
        "Lung Cancer & Thoracic Surgery Directorate, Manchester University NHS Foundation Trust, Manchester, UK"
      ],
      "name": "Haval Balata"
    },
    {
      "affiliations": [
        "Lung Cancer & Thoracic Surgery Directorate, Manchester University NHS Foundation Trust, Manchester, UK",
        "Division of Immunology, Immunity to Infection and Respiratpry Medicine, School of Biological Sciences, The University of Manchester, Manchester, UK"
      ],
      "name": "Phil Crosbie"
    },
    {
      "affiliations": [
        "Lung Cancer & Thoracic Surgery Directorate, Manchester University NHS Foundation Trust, Manchester, UK"
      ],
      "name": "Richard Booton"
    }
  ],
  "title": "Health economic model to evaluate the cost-effectiveness of smoking cessation services integrated within lung cancer screening in the United Kingdom",
  "uid": "79289453-795f-5c48-8adf-f376a9a36af6"
}