{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T06:25:23Z","timestamp":1787120723403,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002908","name":"Stichting Combined Ophthalmic Research Rotterdam","doi-asserted-by":"publisher","award":["2022\/FO387083"],"award-info":[{"award-number":["2022\/FO387083"]}],"id":[{"id":"10.13039\/501100002908","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aim<\/jats:title>\n                    <jats:p>In a randomised open\u2010label trial among hospitalised patients with atherosclerotic vascular disease, motivational smoking cessation counselling with proactive referral to community\u2010based follow\u2010up was more effective than brief cessation advice and written information, with 6\u2010month continuous abstinence rates of 49.5% vs. 24.5%. This study aimed to estimate the cost\u2010effectiveness of this intervention compared with brief cessation advice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Economic evaluation alongside a multicentre, randomised open\u2010label, blinded\u2010endpoint trial with 1:1 randomisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Three secondary care hospitals in Norway. Recruitment took place from November 2021 to October 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Hospitalised patients aged 18\u2009years or older with established atherosclerotic vascular disease who reported smoking at least one cigarette daily before admission were eligible for participation, regardless of whether admission was planned or unplanned. A total of 221 patients were randomised. One participant withdrew informed consent and was excluded from all analyses, leaving 220 participants in the economic evaluation. The cohort comprised 40% women and the mean age was 65.2\u00a0years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Intervention costs included staff training, materials and personnel time. Hospital costs during the 16\u2010month follow\u2010up were estimated using Diagnosis\u2010Related Group cost weights. Survival beyond follow\u2010up was extrapolated using national mortality data adjusted for age, sex and atherosclerotic vascular disease. Lifetime costs were estimated using mean costs from the final six months of follow\u2010up. The primary economic outcome was net monetary benefit (NMB), calculated at a willingness\u2010to\u2010pay threshold of \u20ac38\u2009346 per life\u2010year gained. The incremental cost\u2010effectiveness ratio was also estimated. Future costs and life\u2010years were discounted at 4%. Uncertainty estimates (UE) were obtained using bootstrapping.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>During the 16\u2010month follow\u2010up, five patients (4.6%) died in the intervention group and nine (8.1%) in the control group. Discounted life expectancy from baseline was 13.54\u2009years in the intervention group and 12.47\u2009years in the control group, corresponding to an incremental gain of 1.06 life\u2010years (95% UE = \u22120.72 to 3.31). The incremental discounted lifetime cost was \u20ac3280 per patient (95% UE = \u2013\u20ac19\u2009457 to \u20ac26\u2009436), resulting in an incremental cost\u2010effectiveness ratio of \u20ac3094 per life\u2010year gained. At a willingness\u2010to\u2010pay threshold of \u20ac38\u2009346 per life\u2010year gained, the NMB was \u20ac37\u2009475 (95% UE = \u2013\u20ac15\u2009868 to \u20ac107\u2009797) and the probability of the intervention being cost\u2010effective was 90.5%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Motivational smoking cessation counselling delivered during hospitalisation with proactive referral to community\u2010based follow\u2010up had a high probability of being cost\u2010effective from a hospital perspective for patients with atherosclerotic vascular disease.<\/jats:p>\n                  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