The Use and Impact of Incentives in Population-Based Smoking Cessation Programs: A Review

Abstract

Incentive-based smoking cessation programs that target an entire community have the advantage of reaching a large and diverse group of smokers. They may, however, attract only smokers who are already motivated to quit. Realistically, incentive-based programs aimed at the general population can expect 1% of all their smokers to quit smoking. Quit rates among participants may initially be high (i.e., mean quit rate of 34% at 1-month follow-up) but decrease over time (i.e., mean rate of 23% at 1 year). The results of this review suggest a continued need to establish standard and valid criteria for the evaluation of smoking cessation interventions. Methodological differences among existing studies make them difficult to compare and interpret.

A Randomized Controlled Trial of Financial Incentives for Smoking Cessation

“…Although community organizations may also find this a cost-effective intervention, it may be more difficult to fund these incentive programs through community-based mechanisms. Most commonly, financial incentives have been used to promote smoking cessation in community and worksite settings through a combination of monetary payments, competitions, entries into lotteries, and prizes of cash or merchandise (17). Interpretation of quit rates in these programs is difficult as many of them measure quit rates conditional on program enrollment and are based on nonexperimental designs.…”

“…However, it is unknown whether such incentives can work in the populations of patients who are at highest risk for smoking-related illnesses (long-term heavy smokers), treated in the type of primary care clinical settings where most outpatient care is delivered. Previous studies to evaluate this have been limited by nonexperimental designs, self-reported cessation outcomes, and weak incentives (17,18).…”

Comparing cancer patients who enroll in a smoking cessation program at a comprehensive cancer center with those who decline enrollment

“…35 Second, a range of factors, including the use of financial incentives, demographic factors (eg, ethnicity, age), and smoking-related behavioral characteristics (eg, readiness to quit, amount smoked), distinguish between those who enroll in smoking cessation programs and those who decline. Bains et al 38 and Hennrikus et al 30 reported that monetary incentives increased enrollment among eligible smokers in a cessation program. Woods et al 39 found that, among African-American smokers eligible for a smoking cessation study, decliners were more likely to be men, younger, less educated, and unemployed.…”

Review of strategies to recruit smokers for smoking cessation: a population impact perspective

“…A review on the use and impact of incentives in population-based smoking cessation programs 32 showed that larger incentives were more effective in both influencing smokers' participation and motivating them to quit and remain smoking-free. Elixhauser 33 also reviewed the cost-effectiveness of smoking cessation methods and concluded that interventions specifically aimed at a particular subgroup appeared to be more cost-effective.…”