OBJECTIVES: To evaluate short (12 months) and long term cost-effectiveness (CE) of smoking cessation therapies (willpower, physician advice, nicotine replacement therapies [NRT/inhaler/patch/gum/tablets/spray] and bupropion [BUP]) in Finland. METHODS: A decision analytic model was constructed and analysed from societal viewpoint. Costs included direct costs. Drug prices were retail prices excluding taxes. Drug dosing followed recommendations. Prescription medicine treatments (Rx; NRT/spray, BUP) included the cost of 2 physician visits. Adverse event incidence was assumed 1% in pharmacotherapies. Short term effectiveness (probability to quit) was estimated from those studies included in Cochrane reviews of smoking cessation that fulfilled the inclusion criteria (12 months of continuous abstinence; OTC: level of support low; Rx: level of support low or high, no group therapy) using Mantel-Haenszel weights. Long-term effectiveness (life years saved, LYS) was estimated from age specific differences in life expectancies between smokers and quitters. RESULTS: In the short-term BUP dominated all pharmacotherapies (NRTs), and its cost/quitter was the lowest (1167€), disregarding willpower. The incremental cost/quitter was 1060–1220€ compared to non-pharmacotherapies. In the long term, BUP cost/LYS was the lowest (365€). After 3% discounting of health benefits (LYS) BUP cost/LYS was 898€. The BUP incremental cost/LYS as compared to non-pharmacotherapies was 330–380€ (discounted 820–940€). Sensitivity analyses (effectiveness, adverse events) did not produce changes in BUP's positioning among cessation therapies. CONCLUSIONS: In Finland, BUP is a cost-effective alternative in smoking cessation in short and long-term compared to many other health care interventions.