Abstract Aim To evaluate the cost‐effectiveness of e‐cigarettes as a smoking cessation aid used in routine stop smoking services in England. Design Cost‐effectiveness analysis was performed from the National Health Service (NHS) and Personal Social Services (PSS) perspective for 12‐month periods and life‐time. Costs, including that of both treatments, other smoking cessation help and health‐care services, and health benefits, estimated from EQ‐5D‐5L and measured in quality‐adjusted life‐years (QALYs), for the 12‐month analysis, came from a randomized controlled trial. Life‐time analysis was model‐based with input from both trial data and published secondary data sources. Cost‐effectiveness was measured by an incremental cost‐effectiveness ratio (ICER). Setting Three stop‐smoking service sites in England. Participants Adult smokers (n = 886) who sought help to quit in the participating sites. Intervention and comparator An e‐cigarette (EC) starter kit versus provision of nicotine replacement therapy (NRT) for up to 3 months, both with standard behavioural support. A total of 886 participants were randomized (439 in the EC arm, 447 in the NRT arm). Excluding one death in each arm, the 1‐year quit rate was 18.0 and 9.9%, respectively. Measurements Cost of treatments was estimated from the treatment log. Costs of other smoking cessation help and health‐care services and EQ‐5D‐5 L were collected at baseline, 6‐ and 12‐month follow‐ups. Incremental costs and incremental QALYs were estimated using regression adjusting for baseline covariates and their respective baseline values. Findings The ICER was £1100 per QALY gained at the 12 months after quit date (87% probability below £20 000/QALY). Markov model estimated the life‐time ICER of EC to be £65 per QALY (85% probability below £20 000/QALY). Conclusion Using e‐cigarettes as a smoking cessation aid with standard behavioural support in stop‐smoking services in England is likely to be more cost‐effective than using nicotine replacement therapy in the same setting.

中文翻译：

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英格兰戒烟服务中电子烟与尼古丁替代疗法的成本效益比较（TEC 研究）：一项随机对照试验


摘要 目的 评估电子烟作为英国常规戒烟服务中使用的戒烟辅助手段的成本效益。设计成本效益分析是从国民健康服务 (NHS) 和个人社会服务 (PSS) 的角度进行的，为期 12 个月和终生。在 12 个月的分析中，根据 EQ-5D-5L 估算并以质量调整生命年 (QALY) 衡量的成本，包括两种治疗、其他戒烟帮助和医疗保健服务以及健康益处的成本，得出来自一项随机对照试验。寿命分析是基于模型的，输入来自试验数据和已发布的二手数据源。成本效益通过增量成本效益比（ICER）来衡量。在英格兰设置三个戒烟服务点。参与者 在参与地点寻求戒烟帮助的成年吸烟者 (n = 886)。干预和比较 电子烟 (EC) 入门套件与提供长达 3 个月的尼古丁替代疗法 (NRT)，两者均提供标准行为支持。共有 886 名参与者被随机分配（EC 组 439 名，NRT 组 447 名）。排除各组中的 1 例死亡，1 年戒烟率分别为 18.0% 和 9.9%。测量 根据治疗日志估算治疗成本。在基线、6 个月和 12 个月的随访中收集其他戒烟帮助和医疗保健服务以及 EQ-5D-5 L 的费用。使用基线协变量及其各自基线值的回归调整来估计增量成本和增量 QALY。结果 戒烟后 12 个月内每获得 QALY，ICER 为 1100 英镑（87% 的可能性低于 20 000 英镑/QALY）。 马尔可夫模型估计 EC 的生命周期 ICER 为每 QALY 65 英镑（85% 的概率低于 20 000 英镑/QALY）。结论 在英国的戒烟服务中，使用电子烟作为戒烟辅助手段并提供标准行为支持可能比在相同环境下使用尼古丁替代疗法更具成本效益。