Reducing Smoking in Adolescents: Cost-Effectiveness Results From the Cluster Randomized ASSIST (A Stop Smoking In Schools Trial)
INTRODUCTION: School-based smoking prevention programmes can be effective, but evidence on cost-effectiveness is lacking. We conducted a cost-effectiveness analysis of a school-based "peer-led" intervention. METHODS: We evaluated the ASSIST (A Stop Smoking In Schools Trial) programme in a...
| Main Authors: | , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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Oxford University Press
2012
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| _version_ | 1826280885411905536 |
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| author | Hollingworth, W Cohen, D Hawkins, J Hughes, R Moore, L Holliday, J Audrey, S Starkey, F Campbell, R |
| author_facet | Hollingworth, W Cohen, D Hawkins, J Hughes, R Moore, L Holliday, J Audrey, S Starkey, F Campbell, R |
| author_sort | Hollingworth, W |
| collection | OXFORD |
| description | INTRODUCTION: School-based smoking prevention programmes can be effective, but evidence on cost-effectiveness is lacking. We conducted a cost-effectiveness analysis of a school-based "peer-led" intervention. METHODS: We evaluated the ASSIST (A Stop Smoking In Schools Trial) programme in a cluster randomized controlled trial. The ASSIST programme trained students to act as peer supporters during informal interactions to encourage their peers not to smoke. Fifty-nine secondary schools in England and Wales were randomized to receive the ASSIST programme or usual smoking education. Ten thousand seven hundred and thirty students aged 12-13 years attended participating schools. Previous work has demonstrated that the ASSIST programme achieved a 2.1% (95% CI = 0%-4.2%) reduction in smoking prevalence. We evaluated the public sector cost, prevalence of weekly smoking, and cost per additional student not smoking at 24 months. RESULTS: The ASSIST programme cost of £32 (95% CI = £29.70-£33.80) per student. The incremental cost per student not smoking at 2 years was £1,500 (95% CI = £669-£9,947). Students in intervention schools were less likely to believe that they would be a smoker at age 16 years (odds ratio [OR] = 0.80; 95% CI = 0.66-0.96). CONCLUSIONS: A peer-led intervention reduced smoking among adolescents at a modest cost. The intervention is cost-effective under realistic assumptions regarding the extent to which reductions in adolescent smoking lead to lower smoking prevalence and/or earlier smoking cessation in adulthood. The annual cost of extending the intervention to Year 8 students in all U.K. schools would be in the region of £38 million and could result in 20,400 fewer adolescent smokers. |
| first_indexed | 2024-03-07T00:20:27Z |
| format | Journal article |
| id | oxford-uuid:7c5ee9ea-7ec1-44f0-a829-f15de2271692 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T00:20:27Z |
| publishDate | 2012 |
| publisher | Oxford University Press |
| record_format | dspace |
| spelling | oxford-uuid:7c5ee9ea-7ec1-44f0-a829-f15de22716922022-03-26T20:56:35ZReducing Smoking in Adolescents: Cost-Effectiveness Results From the Cluster Randomized ASSIST (A Stop Smoking In Schools Trial)Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:7c5ee9ea-7ec1-44f0-a829-f15de2271692EnglishSymplectic Elements at OxfordOxford University Press2012Hollingworth, WCohen, DHawkins, JHughes, RMoore, LHolliday, JAudrey, SStarkey, FCampbell, RINTRODUCTION: School-based smoking prevention programmes can be effective, but evidence on cost-effectiveness is lacking. We conducted a cost-effectiveness analysis of a school-based "peer-led" intervention. METHODS: We evaluated the ASSIST (A Stop Smoking In Schools Trial) programme in a cluster randomized controlled trial. The ASSIST programme trained students to act as peer supporters during informal interactions to encourage their peers not to smoke. Fifty-nine secondary schools in England and Wales were randomized to receive the ASSIST programme or usual smoking education. Ten thousand seven hundred and thirty students aged 12-13 years attended participating schools. Previous work has demonstrated that the ASSIST programme achieved a 2.1% (95% CI = 0%-4.2%) reduction in smoking prevalence. We evaluated the public sector cost, prevalence of weekly smoking, and cost per additional student not smoking at 24 months. RESULTS: The ASSIST programme cost of £32 (95% CI = £29.70-£33.80) per student. The incremental cost per student not smoking at 2 years was £1,500 (95% CI = £669-£9,947). Students in intervention schools were less likely to believe that they would be a smoker at age 16 years (odds ratio [OR] = 0.80; 95% CI = 0.66-0.96). CONCLUSIONS: A peer-led intervention reduced smoking among adolescents at a modest cost. The intervention is cost-effective under realistic assumptions regarding the extent to which reductions in adolescent smoking lead to lower smoking prevalence and/or earlier smoking cessation in adulthood. The annual cost of extending the intervention to Year 8 students in all U.K. schools would be in the region of £38 million and could result in 20,400 fewer adolescent smokers. |
| spellingShingle | Hollingworth, W Cohen, D Hawkins, J Hughes, R Moore, L Holliday, J Audrey, S Starkey, F Campbell, R Reducing Smoking in Adolescents: Cost-Effectiveness Results From the Cluster Randomized ASSIST (A Stop Smoking In Schools Trial) |
| title | Reducing Smoking in Adolescents: Cost-Effectiveness Results From the Cluster Randomized ASSIST (A Stop Smoking In Schools Trial) |
| title_full | Reducing Smoking in Adolescents: Cost-Effectiveness Results From the Cluster Randomized ASSIST (A Stop Smoking In Schools Trial) |
| title_fullStr | Reducing Smoking in Adolescents: Cost-Effectiveness Results From the Cluster Randomized ASSIST (A Stop Smoking In Schools Trial) |
| title_full_unstemmed | Reducing Smoking in Adolescents: Cost-Effectiveness Results From the Cluster Randomized ASSIST (A Stop Smoking In Schools Trial) |
| title_short | Reducing Smoking in Adolescents: Cost-Effectiveness Results From the Cluster Randomized ASSIST (A Stop Smoking In Schools Trial) |
| title_sort | reducing smoking in adolescents cost effectiveness results from the cluster randomized assist a stop smoking in schools trial |
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