Financial Incentives Boost Smoking Cessation Rates

Small financial incentives can be an effective motivator to improve adherence in socioeconomically disadvantaged populations participating in smoking cessation treatment, according to research published in the American Journal of Public Health.

Researchers from The University of Texas Health Center at Houston (UTHealth) EDHED identified 146 patients enrolled in the Parkland Smoking Cessation Clinic in Dallas from 2011 to 2013, who were then randomly assigned to either receive usual clinic care — defined by educational orientation session, weekly support group meetings, physician visits, and pharmacological treatment – or the intervention group, which received usual care plus small financial incentives for biochemically confirmed smoking cessation. The patients were “safety net hospital patients,” as the researchers termed, or patients in hospitals that provided care to low income, uninsured, and/or vulnerable populations.

The patient population was 62.3 percent black and 57.5 percent female; about half (52.1 percent) were uninsured and had an annual household income of less than $12,000 (55.5 percent). A majority of the participants (85 percent) were unemployed at the time of the study.

Over the 4 week treatment period, participants in the intervention group had the opportunity to earn up to $150 in gift cards. First they could earn $20 by the specified quit date, which was increased by $5 each week for continued abstinence up to $40. Progress was continually evaluated for 12 weeks after the quit date.

In the intervention group, abstinence rates were significantly higher than regular care groups at each visit following the cessation date. At 4 weeks, the quit rates were 49.3 percent and 25.4 percent among the incentivized group and the usual care group, respectively. At 12 weeks post-cessation, the quit rates were 32.8 percent and 14.1 percent among the intervention and usual care groups, respectively. The intervention group participants earned an average of $63.40 for abstinence during the first 4 weeks after the scheduled quit date.

“We found that women assigned to the financial incentives intervention had the highest cessation rates, which was surprising because women often have lower cessation rates than men participating in treatment,” Darla Kendzor, PhD, professor in the Division of Health Promotion and Behavioral Sciences at UTHealth and primary author of the study explained.

The researchers noted that according to the National Cancer Institute, the average lung cancer treatment ranged from $60,533 to $73,062 per person in 2010. They believed the low cost of this cessation program would outweigh the healthcare costs associated with smoking related illnesses, such as cardiovascular diseases, respiratory diseases, and cancer, especially for the smokers.