A Cochrane review cd004305 1 included 17 studies to answer questions on the importance of financial interventions directed at smokers (covering the costs of treatment) and health care providers in increasing abstinence from smoking. There was a statistically significant favourable effect of full financial interventions directed at smokers on continuous abstinence compared to no interventions (RR 1.77, 95% CI 1.37 to 2.28; 6 studies, n= 9 333). There was also a significant effect of full financial interventions when compared to no interventions on the number of participants making a quit attempt (RR 1.11, 95% CI 1.04 to 1.17; 4 studies, n=9 065). There was a significant effect of financial interventions directed at health care providers in increasing the utilization of behavioural interventions for smoking cessation (RR 1.69, 95% CI 1.01 to 2.86; 3 studies, n= 25 820) but not increasing the use of nicotine replacement therapy and/or bupropion (RR 0.94, 95% CI [0.76 to 1.18; 2 trials, n=2311). Comparison of full benefit with partial or no benefit resulted in costs per additional quitter ranging from $260 to $1453.
Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment, lack of blinding, and more than 20% loss to follow up) and by inconsistency (heterogeneity in populations, interventions and outcomes).
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