The NICE tobacco return on investment tool has been developed to help decision making in tobacco control at local and sub-national levels.

The tool evaluates a portfolio of tobacco control interventions and models the economic returns that can be expected in different payback timescales. Different interventions, including pharmacotherapies and support and advice, can be mixed and matched to see which intervention portfolio or package provides the best ‘value for money’, compared with ‘no-services’ or any other specified package.

Produced for NICE by the Health Economics Research Group (HERG) at Brunel University, the tool is to support commissioners and policy makers, in local authorities and the NHS, in their investment decisions. Select an area of interest using drop down menus, and the tool will automatically estimate the smoking and ex-smoking populations based on up-to-date statistics. This population composition is used to model the impact of smoking on relevant endpoints, taking into account short-, medium- and long-term events.

The tool builds on previous work including work undertaken by HERG on behlaf of Tobacco Free Futures, Fresh Smoke Free North East and Smoke Free South West.

The tool is accompanied by a package of support materials, including a user guide and technical report, and can be downloaded using the links below.

This page contains the most up-to-date tool, so please ensure that you are using the latest version. The most recent version is version 3 check this page regularly to ensure the tool you have downloaded is up to date.

Supporting documents

The tool is accompanied by a user guide and a technical report. We strongly advise that you read these before using the tool.

Video guide

In addition to the user guide and technical report, NICE has also developed a guide on how to use the NICE tobacco return on investment tool.

Changes since version 2

Several changes have been made to the data, which include:

• Relative risks figures are updated using Thun et al. (2000), Health Profile of England (2007), Callum (2004) and Thacker et al. (2007).
• Calculation of passive smoking costs revised to align with estimates provided in RCP (2010) report
• Data tables optimised and restructured: structure of various worksheets reformatted to be in consistent database format to facilitate data lookup and make information more human-readable; Admissions table (now SAF Admissions) entirely restructured and Excel formulae replaced with VBA lookups to reduce system lag, local/regional ICD admissions counts moved to Population Details table for ease of lookup
• Inclusion of the pregnant smokers subpopulation (derived from SATOD rates applied to pregnant population from NHS Maternity Statistics, with a 25% elevation to account for underreporting based on advice from R. West);
• Inclusion of 3 new interventions for the pregnant smoker subpopulation (separate modelling from the general population implemented by the modelling team);
• Inclusion of a new intervention to account for NRT assisted reduction in smoking;
• In Version 2, the GP Brief Advice intervention was applied to the population of smokers who were otherwise unallocated to interventions. This was modified such that GP Brief advice is now allocated in the same proportion to all smoking populations, regardless of other interventions being received. The effectiveness of the GP Brief Advice intervention is now applied as an elevation of the quit rate associated with any existing interventions / natural attrition / etc;
• Region-level employment rate in smokers data added (Integrated Household Survey). This allows for a more dynamic calculation of productivity costs that takes into account regional variations in smoking prevalence and employment rates;
• Average wage rate data added (Annual Survey of Hours and Earnings survey) regional figures now used instead of a single national average, thus better taking into account geographical variations in earnings;
• Option to run a probabilistic sensitivity analysis added.

User interface changes:

The Graphical User Interface has been completely redeveloped for v3, both to improve the user experience and to standardise the layout in line with the wider suite of NICE ROI tools. Main changes include:

• Functionality added to adjust the demographic values for the pregnant smoker subpopulation and employed smoker subpopulation;
• Intervention view redesigned to display all parameters for each intervention (uptake, effectiveness and cost) in the same view;
• Custom intervention functionality extended so that users can now add up to 16 new interventions for inclusion in the Current Package;
• Sub-national Programme now listed separately as an intervention with editable parameters;
• Find Out More options added throughout the tool to provide help to users;
• Package A re-named Current Package once this Current Package is defined, the parameter values for the constituent interventions can be amended to produce a differential, Alternative Package, thus highlighting the impact of making changes to the current provision of services;
• The results section of the tool has been entirely redeveloped and now allows for dynamic changes to made to the package of interventions and their impact to be reviewed in realtime;
• The term Package A+ is no longer used. Instead of having a separate package for local + sub-national strategy, the additive effect of including a subnational strategy is now highlighted in the results display by automatically being added as part of the Alternative Package. In this way, the significant impact of including a subnational strategy is immediately obvious but can be readily excluded from analyses if not relevant to the location in question;
• Options added to adjust scope of results, including the time horizon, discounted cost rate and discounted QALY rate;
• Excel export completely redeveloped into a dynamic dashboard single page interface.

Additional updates made as of December 2014:

• Population figures updated to mid-2013 estimates (ONS)
• Current, ex- and never smoker rates updated to 2013 estimates (IHS)
• LSSS uptake figures updated from available releases for 2013/14 (HSCIC)
• Regional hourly wage rate updated to reflect 2014 figures, including a change to median values for part time and full time workers combined (ASHE)
• Maternity figures updated to reflect 2013/14 datasets (HSCIC)
• SATOD figures updated to reflect the 2013/14 datasets (HSCIC)
• Gender and age stratified smoking prevalence estimates updated to 2013 figures (GLF)
• Fix applied to the charts in the data dashboard (they were previously not updating when changes were made)
• Minor bug fixes applied to the updating of value fields in the GUI

Implementation support tools

In addition to the user guide and technical report, NICE has also developed an audiovisual guide on how to use the NICE tobacco return on investment tool. Please get in touch to tell us what you think of this implementation resource and if there are any outstanding issues you would like us to cover in any future implementation tools we produce.

NICE tobacco return on investment tool implementation resource

NICE tobacco return on investment tool implementation resource

This implementation resource allows you to watch and listen how to use the NICE tobacco return on investment tool.

Key points to note when using the resource:

• We recommend you save this resource to your computer and then open from your hard drive. This will provide you with all of the functionality of the PDF
• To resize the PDF to the size of your screen, once the resource is open, either hold down Ctrl’ and press 0′ (zero) on your keyboard or select View > Zoom > and then select Zoom to page level’ or to screen size’
• You need at least adobe reader version 9 to watch and listen to this resource
• As soon as this resource opens the sound content will start.
• It will take around 30 minutes to watch and listen to this resource in full. Slow the presentation down using the pause button in the bottom left of your screen. If you only wish to view certain chapters you can navigate to these from the contents page
• The written content of this resource provides the same information as the sound content. If you wish to turn the sound off you will not miss information.
• This implementation resource was developed based on version 1 of the Tobacco return on investment tool. This implementation resource remains applicable for newer versions of the Tobacco return on investment tool. If you are using a more up to date version of the Tobacco return on investment tool you may note the data and results differ from those in this implementation resource.

NICE tobacco return on investment tool implementation resource PDF 13 Mb

This is an implementation resource should be used alongside the published NICE tobacco return on investment tool and associated guidance. The information does not supersede or replace the guidance itself.

What do you think?

Please email us with what you think about this implementation resource or if you are experiencing problems accessing this resource implementation@nice.org.uk

NICE would like to thank Mr Adam Lester-George for his help in the development of this implementation resource

Disclaimer

NICE has provided this tool to aid decision-making. NICE cannot be held liable for any investment or other decisions that are made using information and results obtained from this tool. Implementation of NICE guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement NICE guidance, in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in this tool should be interpreted in a way that would be inconsistent with compliance with those duties.