A cost-benefit analysis of smoking cessation programs during the first trimester of pregnancy for the prevention of low birthweight.

Abstract

BACKGROUND: The frequency of low birthweight decreases when women quit smoking in the first trimester of pregnancy. This analysis examines the cost-effectiveness of smoking-cessation programs during pregnancy for the prevention of low birthweight. METHODS: Using data from the 1988 National Health Interview Survey and estimated costs of care for low birthweight and normal birthweight infants, a decision tree was constructed to estimate break-even costs for smoking-cessation programs, assuming a success rate of 18%. Sensitivity analyses were performed to determine how program effectiveness and changes in the population affected the break-even costs. RESULTS: For a population similar to that which participated in the 1988 National Health Interview Survey, smoking-cessation programs would be cost-effective if the program cost $80 or less. In general, to be cost-effective, a smoking-cessation program has to decrease smoking rates by 2.15% to justify every $10 in program costs. Sensitivity analyses showed that as the baseline spontaneous quit rate in the smoking population decreases, smoking-cessation programs of higher cost become more cost-effective. CONCLUSIONS: Smoking cessation programs during pregnancy may be cost-effective for preventing low birthweight if their cost is $80 or less and they achieve success rates of at least 18%.