The cost-effectiveness of improved brief interventions for tobacco cessation in Thailand

Rungrat Palakai; Bundit Sornpaisarn; Yothin Sawangdee; Sutthida Chuanwan; Pairoj Saonuam; Piyawat Katewongsa; Jürgen Rehm

doi:10.3389/fpubh.2023.1289561

The cost-effectiveness of improved brief interventions for tobacco cessation in Thailand

Front Public Health. 2023 Nov 23:11:1289561. doi: 10.3389/fpubh.2023.1289561. eCollection 2023.

Authors

Rungrat Palakai¹, Bundit Sornpaisarn^{2

3

4}, Yothin Sawangdee¹, Sutthida Chuanwan¹, Pairoj Saonuam⁵, Piyawat Katewongsa^{1

6}, Jürgen Rehm^{2

3

7

8

9

10}

Affiliations

¹ Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand.
² Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
³ Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
⁴ Faculty of Public Health, Mahidol University, Bangkok, Thailand.
⁵ Healthy Lifestyle Promotion Section, Thai Health Promotion Foundation, Bangkok, Thailand.
⁶ Thailand Physical Activity Knowledge Development Centre (TPAK), Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand.
⁷ Campbell Family Mental Health Research Institute, CAMH, Toronto, ON, Canada.
⁸ Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
⁹ Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
¹⁰ Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.

Abstract

Background: This study estimated the cost-effectiveness of four strategies enhancing the quality and accessibility of Brief Intervention (BI) service for smoking cessation in Thailand during 2022-2030: (1) current-BI (status quo), (2) the effective-training standard-BI, (3) the current-BI plus the village health volunteers (VHV) mobilization, and (4) the effective-training BI plus VHV mobilization.

Methods: By interviewing five public health officers, nine healthcare professionals aiding these services, and fifteen BI service experts, we explored the status quo situation of the Thai smoking cessation service system, including main activities, their quantity assumptions, and activities' unit prices needed to operate the current cessation service system. Then, we modeled additional activities needed to implement the other three simulated scenarios. We estimated the costs and impacts of implementing these strategies over a nine-year operating horizon (2022-2030), covering 3 years of service system preparation and 6 years of full implementation. The modeled costs of these four strategies included intervention and program costs. The study focused on current smokers age 15 years or older. The assessed impact parameters encompassed smoking prevalence, deaths averted, and healthy life-years gained. An Incremental Cost-Effectiveness Analysis compared the four simulated strategies was employed. Data analysis was performed using the One Health Tool software, which the World Health Organization developed.

Results: The findings of this investigation reveal that all three intervention strategies exhibited cost-effectiveness compared to the prevailing status quo. Among these strategies, Strategy 2, enhancing BI service quality, emerged as the most efficient and efficacious option. Therefore, the expansion of quality services should be synergistically aligned with augmented training, service delivery optimization, and managerial enhancements.

Conclusion: This approach is particularly poised to enhance accessibility to and the efficacy of smoking cessation interventions across Thailand.

Keywords: Thailand; brief intervention (BI); cost-effectiveness analysis; economic evaluation; tobacco cessation.

MeSH terms

Adolescent
Cost-Benefit Analysis
Cost-Effectiveness Analysis
Crisis Intervention
Humans
Thailand / epidemiology
Tobacco Use Cessation*

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The authors gratefully acknowledge the funding from the Thai Health Promotion Foundation with grant number 63-00178. BS and JR acknowledge the funding support from the Canadian Institutes of Health Research’s Institute of Neurosciences, Mental Health and Addiction (Canadian Research Initiative on Substance Misuse Ontario Node Grant SMN-13950).