How Cost-effective is 'No Smoking Day'?

Objective: To obtain a more rigorous estimate of the cost-effectiveness of No Smoking Day (NSD), an annual UK-wide campaign to encourage smokers to quit, than has been possible hitherto.

Design: Comparison of reported quit attempts in the month following NSD for three consecutive years with adjacent months using repeated national surveys of quit attempts.

Setting: England.

Participants: A total of 1309 adults who had smoked in the past year who responded to the surveys in the month following NSD (April 2007-2009) and a comparison group of 2672 adults who smoked in the past year who responded to the survey in the two adjacent months (March and May 2007-2009).

Main Outcome Measures: The number of additional smokers who quit permanently in response to NSD was estimated from the survey results. The incremental cost-effectiveness ratio (ICER) was calculated by combining this estimate with established estimates of life years gained and the known costs of NSD.

Results: The rate of quit attempts was 2.8 percentage points higher in the months following NSD (120/1309) compared with the adjacent months (170/2672; 95% CI 0.99% to 4.62%), leading to an estimated additional 0.07% of the 8.5 million smokers in England quitting permanently in response to NSD. The cost of NSD per smoker was £ 0.088. The discounted life years gained per smoker in the modal age group 35-44 years was 0.00107, resulting in an ICER of £ 82.24 (95% CI 49.7 to 231.6). ICER estimates for other age groups were similar.

Conclusions: NSD emerges as an extremely cost-effective public health intervention.