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Study: Get paid to quit smoking

ct-quitting-smoking-programStudy: Get paid to quit smoking 

A new study found financial incentives inspired some smokers to continue to abstain from smoking.                (Gene J. Puskar / AP 2015)

      Money may help some smokers quit cigarettes for good, a new study suggests.

By paying poor smokers, more than one-third kick the habit long term, Swiss researchers found. The maxi-mum amount issued out was $1,650.

“In relatively low-income smokers who did not receive face-to-face counseling or medications, large financial incentives increase long-term smoking cessation rates,” said lead researcher Jean-Francois Etter, a professor of public health at the Institute of Global Health of the University of Geneva.

Three months after the pay-to-quit program started, 44 percent of smokers who received money said they had been abstinent continuously, compared with 6 percent of those not paid, researchers found.

At six months, 36 percent of the paid group still hadn’t smoked, compared with 6 percent of the others. At 18 months, one in 10 who received money still weren’t smoking versus 4 percent of those who weren’t paid, the researchers found.

Given these findings, “large financial incentives should be further used and tested in studies aimed at documenting the health care costs across a wide array of socio-economic groups,” Etter said.

The study involved 805 low-income smokers who wanted to quit smoking. They were randomly assigned to receive no pay or payments that increased incrementally for confirmed abstinence.

On average, participants had an annual income of about $20,000 and smoked about 16 cigarettes a day. Forty-three percent were students, and 19 percent were unemployed. Whether these incentives would work for richer people isn’t known.

All participants received instructional booklets and access to a website with information about quitting. They were periodically tested to verify whether they were smoking.

Although many participants resumed smoking and 81 dropped out (mostly those not paid), the researchers found a significant number succeeded who were paid to quit.

The report was published Aug. 15 in the Journal of the American College of Cardiology.

“Paying smokers to quit has been found to increase quitting, at least in the short term,” said Judith Prochaska, an associate professor of medicine at Stanford University Medical School in California.

However, key questions remain, she added.

“For example, how large and frequent do the payments need to be?” she wondered. Also, she questioned whether it might be better to pay for participation in quit-smoking programs to build skills and internal motivation, rather than just the out-come of quitting. “Or could a hybrid approach of incentivizing program participation and outcome be even more effective?” Prochaska asked.

Despite the cost, payments may be a productive alternative for certain smokers, Prochaska said.

But existing tobacco treatment approaches with med-cation and counseling may be more accessible for better-educated working people with health insurance, she added.

Because smoking is increasingly concentrated among people with less education and income, reward-based programs have the potential to address growing disparities in tobacco use and tobacco-related diseases, Prochaska said.

“Tobacco addiction is an entrenched societal harm that requires a multipronged approach,” she said. An appropriate approach would combine pharmacological, motivational and behavioral treatments; policies, such as taxation and clean air laws; and new innovations and technologies, she said.

“Incentives have the potential for being part of the solution,” Prochaska said.

    This article is related to:  Medical Research, Human Behavior and Stanford University

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