Objective:

To analyze the cost-effectiveness of various smoking cessation interventions delivered in lung cancer screening settings.

Approach:

• Study Design: The analysis utilized data from four completed SCALE trials, assessing 23 intervention arms differing in counseling and pharmacotherapy intensity.
• Intervention Characteristics: Each intervention included counseling and pharmacotherapy, with intensity categorized based on expert opinion.
• Outcome Measurement: The primary outcome was self-reported 7-day point prevalence abstinence assessed at 6 or 12 months post-randomization.
• Modeling Approach: The study employed the CISNET microsimulation model to project long-term health and economic outcomes.

Key Findings:

• The analysis included 23 intervention arms from four trials, focusing on varying intensities of counseling and pharmacotherapy.
• Interventions were categorized into eight composite treatment classes based on counseling and pharmacotherapy intensity.
• The study followed the CHEERS 2022 reporting guideline for economic evaluations.

Interpretation:

- The results indicate that certain high-intensity smoking cessation interventions are more cost-effective than others, particularly when integrated into lung cancer screening programs. This suggests that enhancing the intensity of counseling and pharmacotherapy can lead to better smoking cessation outcomes and potentially reduce healthcare costs associated with smoking-related diseases.

Limitations:

• Not all SCALE trials assessed long-term health and economic consequences.
• Variability in race categorization and self-reporting may affect generalizability.

Conclusion:

- Implementing effective smoking cessation strategies within lung cancer screening programs can significantly improve public health outcomes. Policymakers should consider prioritizing high-intensity interventions to maximize both health benefits and cost savings in lung cancer prevention efforts.