Life Years Saved, Quality-Adjusted Life Years Saved and Cost-Effectiveness of a School-Based Tobacco Prevention Program

  • L. Y. Wang
  • C. Linda
  • R. Lowry
  • G. Tao
Reference work entry


Project Toward No Tobacco Use (TNT) is a school-based education curriculum designed to prevent tobacco use among junior and senior high school students. An efficacy evaluation of Project TNT showed that a combined-strategy curriculum was effective in reducing both trial and weekly cigarette use. During the 2 years, trial cigarette use among intervention students increased from 37 to 53%, and weekly use increased from 6 to 10%. Among control students, trial cigarette use increased from 35 to 58%, and weekly cigarette use increased from 4 to 13%. On the basis of these findings, we conducted an economic evaluation to determine the cost-effectiveness of Project TNT. The benefits measured were life years (LYs) saved,  quality-adjusted life years (QALYs) saved, and medical care costs saved under a 3% discount rate. The costs measured were the costs of Project TNT program. We quantified TNT’s cost-effectiveness as cost per LY saved and cost per QALY saved. Under base case assumptions, at an intervention cost of $16,403, Project TNT prevented an estimated 34.9 students from becoming  established smokers. As a result, we estimated a cost savings of $10,733 accompanying every LY saved and a cost savings of $7,667 accompanying every QALY saved. Results showed TNT to be cost saving over a reasonable range of model parameter estimates. Project TNT is highly cost-effective compared with other widely accepted prevention interventions. School-based prevention programs of this type warrant careful consideration by policy makers and program planners.


National Health Interview Survey Smokeless Tobacco Medical Care Cost HRQL Score Senior High School Student 

List of Abbreviations:


Centers for Disease Control and Prevention


health-related quality of life


Institute of Medicine


life years

Project TNT

Project Toward no Tobacco Use


quality-adjusted life years


Substance Abuse and Mental Health Services Administration


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© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • L. Y. Wang
  • C. Linda
  • R. Lowry
  • G. Tao

There are no affiliations available

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