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Financial incentives help low-income adults quit smoking
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Financial incentives raised smoking cessation rates among low-income smokers, according to a study published in the Journal of the American College of Cardiology.
Jean-François Etter, PhD, and Felicia Schmid, MA, from the Institute of Global Health at the University of Geneva, analyzed data from 805 low-income smokers recruited from the general population in Geneva from 2011 to 2013.
The cohort was randomly assigned to incentive (n = 401) or control (n = 404) groups. Both groups also received booklets and access to a smoking cessation website. The intervention group received incremental financial incentives up to a maximum equivalent of $1,650. The control group received no financial bonuses.
Payments were offered for biochemically verified abstinence at 1, 2 and 3 weeks and 1, 3 and 6 months. The researchers provided no in-person or phone counseling or contributing medications. The primary outcome was avoidance of smoking as measured by expired carbon monoxide and salivary cotinine at 6 months (the end of the incentive program) and at 18 months, 1 year after the end of the program.
The researchers found that rates of continuous abstinence were 9.5% for the incentive group and 3.7% for the control cohort between 6 and 18 months (P = .001). The rates of abstinence in the incentive group vs. the control group were higher at 3 months (54.9% vs. 11.9%; P < .001), 6 months (44.6% vs. 11.1%; P < .001) and 18 months (18.2% vs. 11.4%; P = .006).
In an accompanying editorial, Joseph A. Ladapo, MD, PhD, assistant professor of population health and medicine at New York University School of Medicine, and Judith J. Prochaska, PhD, MPH, associate professor of medicine at the Stanford Prevention Research Center, Stanford University, wrote the incentive encouraged positive behaviors in the intervention group.
Joseph A. Ladapo
“The intervention group was significantly more likely than the control group to read the cessation booklet (64% vs. 55%), access online cessation help (20% vs. 14%) and register a supporter (8% vs. 3%),” Ladapo and Prochaska wrote. “Furthermore, the intervention group was more likely to provide biochemical verification of their self-reported abstinence out to the 6-month follow-up (83% vs. 68%) and with lower attrition out to 18 months (7% vs. 13%).” – by James Clark
Disclosure: The researchers and Ladapo report no relevant financial disclosures. Prochaska reports consulting for Pfizer.
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