Grant: Project Grant

Healthcare service use and costs of current of smokers are higher than those of non-smokers. This fact highlights the healthcare burden that results from smoking and suggests benefits of interventions that decrease smoking prevalence. There are evidence-based treatments that can help smokers quit. Studies of such treatments are usually judged only on how effective they are in helping smokers achieve full abstinence at a particular time point. This narrow focus does not reflect the variation in cessation trajectories of smokers who lapse and relapse during a quit attempt, employ a reduce-to-quit strategy, or seek to reduce, but not quit, smoking. Nor does it speak to the ultimate reason for funding large-scale interventions: improving the health of smokers and avoiding the healthcare burden associated with treating continuing smokers. The Smoking Treatment for Ontario Patients program is a publicly-funded smoking cessation treatment program accessed by 25,000 smokers per year in over 300 health care organizations. Treatment is individually tailored, and within a one year episode of care, there is no set number or frequency of clinical care visits. Evaluation is currently limited to survey questions answered by a portion of patients, which, in the context of a relapsing remitting condition, provide a slim understanding of the effects of receiving smoking cessation treatment. Healthcare use data provide an objective means by which to determine effects. We will use a database of patients who received STOP smoking cessation treatments, a population-based comparison group of smokers who did not receive STOP smoking cessation treatments, and population-based healthcare databases (e.g. physician billings, emergency room and hospital visits) to compare health and healthcare use between groups of smokers. This information can be used to help inform debates concerning how to best implement smoking cessation services within the publicly funded healthcare system in Ontario.