Financial Incentives to Improve Smoking Cessation
Scott Halpern, MD, PhD
Kevin Volpp, MD, PhD
Smoking remains the leading cause of preventable illness and death in the United States. Previous studies have shown that financial incentives improve abstinence rates, but questions remain about effectiveness when it comes to participants, incentive design, and combinations of interventions.
Researchers at the University of Pennsylvania leveraged Way to Health to compare five approaches to smoking cessation in a randomized controlled trial. The study enrolled 6,006 smokers from 54 companies for six months with an opt-out consent process. Participants in the "usual care” group received information and motivational text messages. The intervention groups additionally received 1) cessation aids such as nicotine-replacement therapy or pharmacotherapy, 2) e-cigarettes, 3) cessation aids plus a gain-framed financial incentive, or 4) cessation aids with a loss-framed financial incentive (deposit contract).
Participants receiving financial incentives and free cessation aids showed higher rates of sustained smoking abstinence than those receiving free cessation aids alone. There was no significant difference in quit rates between the deposit contract and standard reward groups. Among smokers who received usual care, the addition of free cessation aids or e-cigarettes did not provide a benefit.