More Evidence Paying Smokers to Quit May Work

But cost may be $28,000 to get one additional smoker to succeed long term

TUESDAY, Aug. 16, 2016 (HealthDay News) -- Financial incentives may boost smoking cessation rates, according to a study published in the Aug. 23 issue of the Journal of the American College of Cardiology.

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. All participants received instructional booklets and access to a website with information about quitting. They were periodically tested to verify whether or not they were smoking.

Although many participants resumed smoking and 81 dropped out (mostly those not paid), the researchers found a significant number who were paid to quit succeeded. Three months after the pay-to-quit program started, 44.4 percent of smokers who received money said they had been abstinent continuously, compared with 6.4 percent of those not paid. Even after incentive payments stopped at six months, those paid to quit were more likely to stay off cigarettes. At six months, 35.9 percent of the paid group still hadn't smoked, compared with 5.7 percent of the others. At 18 months, one in 10 (9.5 percent) who received money still weren't smoking versus 3.7 percent of those who weren't paid.

Judith Prochaska, Ph.D., M.P.H., an associate professor of medicine at the Stanford University Medical School in California, coauthor of an accompanying journal editorial, pointed out the 6 percentage point difference between paid and unpaid groups after 18 months. Seventeen people would need to go through an incentive program to get one to quit, she told HealthDay, adding it would cost $28,000 to get one additional smoker to succeed long term. Despite the cost, payments may be a productive alternative for certain smokers. "Paying smokers to quit has been found to increase quitting, at least in the short-term," Prochaska said.

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