Cost and effectiveness of the nationwide government-supported Smoking Cessation Clinics in the Republic of Korea

OBJECTIVE: In the Republic of Korea, nationwide government-supported Smoking Cessation Clinics have been operating in 253 public health centres since 2004, but the cost and effectiveness of the service have yet to be evaluated. METHODS: The cost of the service (staff salary, medication, education and promotion and overhead) was calculated from the Smoking Cessation Clinic's 2009 financial report. The number of service users, self-reported 4-week and 6-month quit rates and the proportion of nicotine replacement therapy users were collected from the service's performance monitoring data. Long-term quit rate and life-years saved by quitting were estimated and used in addition to monitoring data to evaluate the effectiveness of the service. RESULTS: A total of 354 554 smokers used the Smoking Cessation Clinics in 2009. The self-reported 4-week and 6-month quit rates were 78% and 40%, respectively. Estimated 1-year and 8-year quit rates were 28.1% and 12.9%, respectively. The cost of the service in 2009 was US$21 127 thousand. Cost per service user who set a quit date was US$60. Cost per service user who maintained cessation at 4 weeks, 6 months and 1 year was US$76, US$149 and US$212, respectively. When considering 8-year quit rates, the cost per life-year saved was estimated at US$128 in the base scenario and increased to US$230 in the worst-case scenario. CONCLUSION: The nationwide government-supported public health centre-based Smoking Cessation Clinics provided highly cost-effective service at a level of 0.46% of the per capita gross domestic product.ope