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Health: helping smokers to quit

Some 22.7 per cent of people aged 15 years and over smoke

A recent health technology assessment (HTA) by the Health Information and Quality Authority (Hiqa) provides clear evidence of how to best help smokers quit cigarettes. It is the first analysis carried out to compare the cost-effectiveness of alternative mixes of smoking cessation interventions with an existing standard of care, and the first assessment in the EU to examine the cost-effectiveness of e-cigarettes as an intervention to help people quit smoking.

Hiqa has formally advised Minister for Health Simon Harris that investing in smoking cessation interventions is effective and provides good value for money

Although all interventions are effective at helping people to stop smoking, those who use smoking cessation aids are more successful. According to the HTA, using the drug varenicline (either alone or in combination with nicotine replacement therapy [NRT]) offers the best chance of successfully quitting. Hiqa has now formally advised Minister for Health Simon Harris that investing in smoking cessation interventions is effective and provides good value for money.

The prevalence of smoking in the Republic is 22.7 per cent in people aged 15 years and over. The prevalence is higher in men (24.3 per cent) than women (21.2 per cent), and has been in decline since 2008. Of the 820,000 smokers in Ireland, about half make at least one attempt to quit each year.

"There is some concern that e-cigarettes may provide a gateway to tobacco use by people who had previously never smoked. However, ongoing research into this and the long-term safety of e-cigarettes should clarify these concerns."

A substantial proportion of smokers use e-cigarettes as an aid to quitting smoking. Although Hiqa stopped short of formally recommending e-cigarettes – noting “there was not enough evidence at present to reliably demonstrate their effectiveness as an aid to smoking cessation”– further research appears likely to confirm their cost effectiveness. There is some concern that e-cigarettes may provide a gateway to tobacco use by people who had previously never smoked. However, ongoing research into this and the long-term safety of e-cigarettes should clarify these concerns.

The annual additional cost of maximising the use of the combination of varenicline and NRT would be approximately €7 million, the report says; the Minister for Health must make funding this a priority in upcoming budget negotiations.