SynthesisThe European journal of health economics : HEPAC : health economics in prevention and care2026
Breaking the habit: a systematic review of the cost-effectiveness of non-pharmacological and combined interventions for smoking cessation in Europe.
Synthesis in The European journal of health economics : HEPAC : health economics in prevention and care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSmoking is one of the main causes of preventable disease and premature death. While existing evidence syntheses the cost-effectiveness of smoking cessation interventions for hospitalized patients and high-risk groups such as pregnant women or children, the evidence on the cost-effectiveness of non-pharmacological interventions for the general population remains relatively underdeveloped.
methodsA systematic literature review was performed using MEDLINE, EMBASE, Cochrane Library, and NHS Health Economic Evaluation Database along with grey literature, pre-prints, and HTA reports.
resultsA total of 9,541 abstracts were screened, with 23 studies meeting the eligibility criteria. These studies focused on four main intervention types (i) face-to-face counseling, (ii) digital/telephone counseling, (iii) reimbursement, and (iv) awareness building. The ICERs ranged from - 332,320 EUR/QALY to 156,310 EUR/QALY. Of the 39 ICERs reported, 30 (76.9%) demonstrated superior cost-effectiveness for smoking cessation interventions. Nine studies reported strong dominance, where the intervention not only gained QALYs but also saved costs. On average, 0.02 QALYs (SD = 0.02) were gained per person. When Life-Years Saved (LYS) were used as the effectiveness measure with a range from EUR 192/LYS to EUR 17,908/LYS. All ICERs werebelow the EUR 25,000/LYS willingness to pay threshold.
conclusionThe evidence suggests that smoking cessation interventions are general cost-effective in Europe. Personal counseling appears crucial for digital interventions to demonstrate cost-effectiveness. Also, awareness building could serve as a cost-effective means of supporting existing cessation programs.
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