Would vaccination against nicotine be a cost-effective way to prevent smoking uptake in adolescents?

Gartner, Coral E., Barendregt, Jan J., Wallace, Angela and Hall, Wayne D. (2012) Would vaccination against nicotine be a cost-effective way to prevent smoking uptake in adolescents?. Addiction, 107 4: 801-809. doi:10.1111/j.1360-0443.2011.03718.x

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Author Gartner, Coral E.
Barendregt, Jan J.
Wallace, Angela
Hall, Wayne D.
Title Would vaccination against nicotine be a cost-effective way to prevent smoking uptake in adolescents?
Journal name Addiction   Check publisher's open access policy
ISSN 0965-2140
1360-0443
Publication date 2012-04
Sub-type Article (original research)
DOI 10.1111/j.1360-0443.2011.03718.x
Open Access Status File (Author Post-print)
Volume 107
Issue 4
Start page 801
End page 809
Total pages 9
Place of publication Oxford, U.K.
Publisher Wiley-Blackwell Publishing
Collection year 2013
Language eng
Formatted abstract
Aims We used epidemiological modelling to assess whether nicotine vaccines would be a cost-effective way of preventing smoking uptake in adolescents.

Design, Setting, Participants and Measurements We built an epidemiological model using Australian data on age-specific smoking prevalence; smoking cessation and relapse rates; life-time sex-specific disability-adjusted life years lived for cohorts of 100 000 smokers and non-smokers; government data on the costs of delivering a vaccination programme by general practitioners; and a range of plausible and optimistic estimates of vaccine cost, efficacy and immune response rates based on clinical trial results. We first estimated the smoking uptake rates for Australians aged 12–19 years. We then used these estimates to predict the expected smoking prevalence in a birth cohort aged 12 in 2003 by age 20 under (i) current policy and (ii) different vaccination scenarios that varied in cost, initial vaccination uptake, yearly re-vaccination rates, efficacy and a favourable vaccine immune response rate.

Findings Under the most optimistic assumptions, the cost to avert a smoker at age 20 was $44 431 [95% confidence interval (CI) $40 023–49 250]. This increased to $296 019 (95% CI $252 307–$355 930) under more plausible scenarios. The vaccine programme was not cost-effective under any scenario.

Conclusions A preventive nicotine vaccination programme is unlikely to be cost-effective. The total cost of a universal vaccination programme would be high and its impact on population smoking prevalence negligible. For these reasons, such a programme is unlikely to be publicly funded in Australia or any other developed country.
Keyword Cost effectiveness
Modelling
Nicotine dependence
Nicotine vaccine
Preventive vaccination
Smoking
Smoking prevention
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article first published online: 23 JAN 2012.

 
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Created: Tue, 06 Mar 2012, 13:41:36 EST by Wayne Hall on behalf of Queensland Brain Institute