University-Based Smoking Cessation Program Through Pharmacist-Physician Initiative: An Economic Evaluation

Introduction: Annually, especially in poor resourced countries, significant amount of money is spent to treat chronic diseases. The money instead could be saved by spending on health promotion programs for preventing chronic diseases. Aim: To conduct cost-effectiveness analysis of various intervention modules in the "Smoking Cessation" program conducted in Universiti Sains Malaysia (USM). Materials and Methods: This was an observational study design. Cost-effectiveness analysis was used to assess the costs and outcomes of the intervention. Data were collected retrospectively from medical records of all clients (n=129) and then all the participants were followed-up for at least 6 months from the date of participation. Data were analysed descriptively using frequency (%) and mean (sd). Kolmogorov-Smirnov test was carried out to test for normality. Chi-square and Kruskal-Wallis tests were used at alpha level of 0.05. All analyses were done using SPSS version 19. Results: The findings of the study showed that the majority of participants were Malays (n=108; 83.7%), males (n=128; 99.2%), USM's staff (n=71; 55.0%) and within an age group of 23 years or less (n=38; 29.5%). Among those who successfully quit were male (n=30; 100%), Malays (n=29; 96.7%), staff (n=19; 63.3%), moreover, their age ranged from 35 to 56-year-old (n=15; 50.0%). Further analysis of data showed that there were significant associations between success rate and modules of intervention, occupation, motivation factors, and frequency of counselling. Total cost of the Smoking Cessation Program was MYR 38,634.66 (during a period of 34.5 months), with a success rate equal to 29.1%. The most cost-effective module of intervention was counselling alone (CE ratio equal to MYR360.00 per 1% of success rate). The study found counselling with patch was ineffective during the study period. Conclusion: Counselling alone module was the most cost-effective in Smoking Cessation program conducted in USM, Malaysia.