Assistance to quit smoking in Scotland: a tangential analysis

From today's PhysOrg:

The pilot scheme to be tried in Dundee, north of Edinburgh, will see smokers offered 12.50 pounds (15.8 euros, 24.7 dollars) per week to quit. Health bosses hope that 900 smokers will give up as a result in the next two years.

This program is based on an apparently successful previous program called: Give it up for baby. As of the end of September 2007 thirty-one women were recruited in the program, with a 95% pass rate based on weekly carbon monoxide breath tests. From the December 10, 2007 progress report for the program:

The scheme has paid £1,760 to the women as credits to be claimed against fresh food and groceries at ASDA. The first birth of an infant under the scheme has taken place, with both the mother and father having given up smoking.
...
No significant operational issues have affected the provision of the scheme. No significant risk issues have been identified.

I've not found more recent results, but it seems that things are going well. However, a basic economic analysis of future cost-savings would be useful. However, I've not found any such analysis in the summary, so I decided to do really basic back-of-the-envelope calculations to see what sort of benefit the "Give it up for baby" scheme might have. First, I had to find out what sort of things the British press reports, viz health risks caused by smoking during pregnancy in the UK.

From The Independent (March 2, 2002):

Pregnant smokers are a further cause for concern, with higher risks of miscarriage, reduced birthweight, and perinatal death. For parents who continue to smoke after birth, there is an increased risk of cot death and the children themselves are more likely to take it up. The highest smoking rates found among expectant mothers are closely related to health inequalities.
...
Pregnant women who smoke are a key focus of action as smoking cessation services are developed. The Government's latest infant feeding survey figures show a 5 per cent drop in the number of pregnant women smoking since 1995, and pounds 3m has been invested in training and appointing midwives to co-ordinate antenatal and postnatal smoking cessation services, giving specialist advice. A new national NHS helpline for pregnant smokers wishing to quit has also been set up.

Areas of cost savings for the woman include cigarettes at roughly ~£490 (based on a median cigarette usage over a 280-day pregnancy of 7 cigarettes/day, 20 cigarettes/pack, and a cost of £5/pack*), for a low birth-weight baby £50,000 (based on a low value of $100,000 in the United States in 2000 dollars and exchange rate of £1=$2), and funeral costs due to perinatal death £2,048 (based on median British funeral cost) give an estimated (low) cost savings to the mother of £52,538. This doesn't even cover the costs of possible counseling and ancillary costs due to lost time at work, for example. Admittedly, I would imagine that the NHS would cover some (or a lot) of the £50,000 I'm listing as care for a low birth-weight baby, but even if it is covered by a negligible co-pay, the direct costs are still high.

In 1998, the British government released a report stating that smoking costs the NHS £1.4 billion each year. If we assume that the NHS picks up the majority of the bill for the estimated £50,000 listed above, then even for the small sample size of this program (31 women), the NHS saves a possible £1.55 million at the expenditure of only a few thousand pounds. If this was expanded to the rest of Scotland, the NHS may well see large-scale results.

The figure of £1.4 billion provides a scale of how much cost-savings the NHS would see if the Scottish scheme a) worked, and b) was used throughout the country. Already, the UK has mandated a smoking ban in all public buildings throughout the country (including pubs, mind). Of course, after the UK gains the benefits of cost-abatement due to a more healthy society, it will inevitably have to deal with the costs of a society that has lived longer than previously would have - increased costs for senior living...

* The NHS has a nifty little Flash applet on personal costs of cigarettes.