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Steven R. Cummings, MD; Susan M. Rubin, MPH; Gerry Oster, PhD

JAMA. 1989;261(1):75-79.

Abstract
Cigarette smoking is the most important preventable cause of death in the United States. Surveys of patients, however, suggest that many physicians do not routinely counsel smokers to quit. Because physicians may not consider counseling against smoking to be as worthwhile as other medical practices, we examined its cost-effectiveness. We based our estimates of the effectiveness of physician counseling on published reports of randomized trials and our estimates of its cost on average charges for physician office visits. Our results indicate that the cost-effectiveness of brief advice during routine office visits ranges from $705 to $988 per year of life saved for men and from $1204 to $2058 for women. Follow-up visits about smoking appear to be similarly cost-effective. Physician counseling against smoking, therefore, is at least as cost-effective as several other preventive medical practices and should be a routine part of health care for patients who smoke.

(JAMA 1989;261:75-79)

Author Affiliations
From the Division of General Internal Medicine, Department of Medicine (Dr Cummings and Ms Rubin), and the Clinical Epidemiology Program (Dr Cummings), University of California, San Francisco; and Policy Analysis Inc, Brookline, Mass (Dr Oster).

Footnotes
Reprint requests to University of California Medical Center, 400 Parnassus Ave, A-405, San Francisco, CA 94143-0320 (Dr Cummings).

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References
Circulation 2002;106:3373-3421.
FULL TEXT  

Cost-Effectiveness of Chemotherapy in Non-Small-Cell Lung Cancer
Saglam et al.
JCO 2002;20:3750-3752.
FULL TEXT  

Task Force #2--the cost of prevention: can we afford it? Can we afford not to do it?
Krumholz et al.
J Am Coll Cardiol 2002;40:603-615.
FULL TEXT  

Avoiding High-Risk Behaviors: Smoking Prevention and Cessation in Diabetes Care
Tibbs and Haire-Joshu
Diabetes Spectr. 2002;15:164-169.
ABSTRACT | FULL TEXT  

Coverage of Smoking Cessation Treatment by Union Health and Welfare Funds
Barbeau et al.
AJPH 2001;91:1412-1415.
ABSTRACT | FULL TEXT  

Cost-effectiveness of a School-Based Tobacco-Use Prevention Program
Wang et al.
Arch Pediatr Adolesc Med 2001;155:1043-1050.
ABSTRACT | FULL TEXT  

Physicians' attitudes towards prevention: importance of intervention-specific barriers and physicians' health habits
Cornuz et al.
Fam Pract 2000;17:535-540.
ABSTRACT | FULL TEXT  

Injury death excesses in smokers: a 1990-95 United States national cohort study
Leistikow et al.
Inj. Prev. 2000;6:277-280.
ABSTRACT | FULL TEXT  

Barriers Pediatricians Face When Using Asthma Practice Guidelines
Cabana et al.
Arch Pediatr Adolesc Med 2000;154:685-693.
ABSTRACT | FULL TEXT  

A Clinical Practice Guideline for Treating Tobacco Use and Dependence: A US Public Health Service Report
The Tobacco Use and Dependence Clinical Practice G
JAMA 2000;283:3244-3254.
ABSTRACT | FULL TEXT  

Why Don't Physicians Follow Clinical Practice Guidelines?: A Framework for Improvement
Cabana et al.
JAMA 1999;282:1458-1465.
ABSTRACT | FULL TEXT  

Perceived Risks of Heart Disease and Cancer Among Cigarette Smokers
Ayanian and Cleary
JAMA 1999;281:1019-1021.
ABSTRACT | FULL TEXT  

Tools to Improve Documentation of Smoking Status: Continuous Quality Improvement and Electronic Medical Records
Spencer et al.
Arch Fam Med 1999;8:18-22.
ABSTRACT | FULL TEXT  

A smoking cessation counsellor: should every hospital have one?
Prathiba et al.
The Journal of the Royal Society for the Promotion of Health 1998;118:356-359.
ABSTRACT  

Use and Cost Effectiveness of Smoking-Cessation Services under Four Insurance Plans in a Health Maintenance Organization
Curry et al.
NEJM 1998;339:673-679.
ABSTRACT | FULL TEXT  

A comprehensive smoking cessation programme after surgery increased 1 year quit rates
Todd
Evid. Based Nurs. 1998;1:46-46.
FULL TEXT  

Cost-effectiveness of the Clinical Practice Recommendations in the AHCPR Guideline for Smoking Cessation
Cromwell et al.
JAMA 1997;278:1759-1766.
ABSTRACT  

The Relationship Between Patient Income and Physician Discussion of Health Risk Behaviors
Taira et al.
JAMA 1997;278:1412-1417.
ABSTRACT  

What can be concluded from the Oxcheck and British family heart studies: commentary on cost effectiveness analyses
Wonderling et al.
BMJ 1996;312:1274-1278.
ABSTRACT | FULL TEXT  

Cost-effectiveness of the Transdermal Nicotine Patch as an Adjunct to Physicians' Smoking Cessation Counseling
Fiscella and Franks
JAMA 1996;275:1247-1251.
ABSTRACT  

The Agency for Health Care Policy and Research Smoking Cessation Clinical Practice Guideline
Smoking Cessation Clinical Practice Guideline Pane et al.
JAMA 1996;275:1270-1280.
ABSTRACT  

Environmental and Policy Interventions to Control Tobacco Use and Prevent Cardiovascular Disease
Brownson et al.
Health Educ Behav 1995;22:478-498.
ABSTRACT  

The Cost-effectiveness of HMG-CoA Reductase Inhibitors to Prevent Coronary Heart Disease: Estimating the Benefits of Increasing HDL-C
Hamilton et al.
JAMA 1995;273:1032-1038.
ABSTRACT  

Painful vs Painless Cost Control
Grumbach and Bodenheimer
JAMA 1994;272:1458-1464.
ABSTRACT  

Where Is the Health in Health System Reform?
Fielding and Halfon
JAMA 1994;272:1292-1296.
ABSTRACT  

How Much Is Too Much? Advising Patients About Safe Levels of Alcohol Consumption
Bradley et al.
Arch Intern Med 1993;153:2734-2740.
ABSTRACT  

Physician and Other Health Care Professional Counseling of Smokers to Quit--United States, 1991
JAMA 1993;270:2536-2537.
 

Health Insurance Coverage for Smoking Cessation Services
Schauffler and Parkinson
Health Educ Behav 1993;20:185-206.
ABSTRACT  

Public Health Focus: Effectiveness of Smoking-Control Strategies--United States
JAMA 1992;268:1645-1646.
 

Treatment for Cigarette Smoking in a Department of Veterans Affairs Outpatient Clinic
Weissfeld and Holloway
Arch Intern Med 1991;151:973-977.
ABSTRACT  

Cost Effectiveness of Low-Dose Zidovudine Therapy for Asymptomatic Patients with Human Immunodeficiency Virus (HIV) Infection
Schulman et al.
ANN INTERN MED 1991;114:798-802.
ABSTRACT  

Smoking in Older Women: Is Being Female a 'Risk Factor' for Continued Cigarette Use?
King et al.
Arch Intern Med 1990;150:1841-1846.
ABSTRACT  

A Comparison of Two Methods to Recruit Physicians to Deliver Smoking Cessation Interventions
Kottke et al.
Arch Intern Med 1990;150:1477-1481.
ABSTRACT  

Education for Health: A Role for Physicians and the Efficacy of Health Education Efforts
Council on Scientific Affairs
JAMA 1990;263:1816-1819.
ABSTRACT  

Randomized, Controlled Trial of Clonidine for Smoking Cessation in a Primary Care Setting
Franks et al.
JAMA 1989;262:3011-3013.
ABSTRACT  

Clinical Economics: A Guide to the Economic Analysis of Clinical Practices
Eisenberg
JAMA 1989;262:2879-2886.
ABSTRACT  

Advising Parents to Stop Smoking: Opportunities and Barriers in Pediatric Practice
Frankowski and Secker-Walker
Arch Pediatr Adolesc Med 1989;143:1091-1094.
ABSTRACT