Smoking Cessation: A Case Study of a Pilot Integrated Programme in Qingdao, China

Background: China is the largest producer and consumer of tobacco. A cost-of-illness study suggested that the healthcare cost and productivity loss incurred to the society due to smoking was US$28.9 billion in 2008. The government is increasingly aware of the long-term social and economic impact of smoking in recent years. Hence, various tobacco control measures have been implemented nationwide since 2009. Tobacco dependence management is an evidence-based intervention, recommended by the WHO as a way to increase cessation rates. However, the high cost of treatment might deter smokers from enrolling into the program. Objectives: The aim of this paper is to share our pilot experience in designing and implementing an integrated tobacco dependence management program in 2014 in Qingdao, and to provide preliminary results of the program. Method: In order to effectively improve uptake of the intervention and overall treatment outcomes, a pilot integrated tobacco dependence management program was conducted in Qingdao with 6 key initiatives namely: 1) new collaborative model across different government agencies, 2) partnership strategy between government and the private sector, 3) funding mechanism of the program, 4) introduction of new payment method, 5) development of electronic medical records, and 6) management of associated medical risk and fraud. To evaluate the outcomes of this integrated program, 1000 participants were interviewed and follow-up visited for 6 times. Various indicators had been collected for assessment on tobacco dependence management, including spending on smoking, nicotine dependence  grade  and carbon  monoxide  concentration  after  dependence treatment. Results: The primary results of the pilot study found that of the completed follow-up cases (828), more than 60% of the study participants quit smoking successfully. From the societal perspective, there are long-term cost-savings from an integrated tobacco dependence management program in China.