Recommendations

• Cessation interventions (counseling and pharmacotherapy) should be covered under both public and private health insurance plans.
• In regions or countries where cost is a barrier to access, low-intensity interventions such as counseling (face-to-face, internet-based email, chat rooms, etc), telephone counseling, and the use of self-help materials should be utilized to help smokers quit and maintain abstinence.
• Smoking cessation promotion is cost-effective when NRT products are used. NRT combined with face-to-face or telephone counseling is more cost-effective compared to NRT or counseling alone; therefore, the combination should be promoted when economically feasible.
• As a viable, effective and cost-effective treatment, NRT should be available and affordable for general sale (over-the-counter, OTC).
• The planning of smoking cessation services should place special emphasis on groups in society where smoking is most prevalent. These would comprise the poor and less educated. Such a focus would reduce the disparities in health attributable to tobacco use.
• Simple briefs outlining the social and economic benefits of smoking cessation should be prepared and disseminated among political decision-makers to promote understanding and to support the drafting and implementation of strong public policies and effective health strategies.
• Research should continue on the costs and cost-effectiveness of interventions pharmacotherapy, interventions for cessation of non-cigarette forms of tobacco (smokeless tobacco, cigar or pipe smoking).
• Interventions must be tailored to reach high-risk populations, including pregnant women, youth who use tobacco, itinerant workers, language minorities, and other groups for which recruitment into cessation programs is a special challenge.
• In light of the obstacle that longer smoking duration poses to successful cessation, programs to prevent uptake and to prompt early cessation are crucial.
• Given the very limited research on the economics of smoking cessation, development of adequate surveillance systems should be a priority and research and evaluation should be included as key elements.