A Randomized, Controlled Trial of Financial Incentives for Smoking Cessation
Open accessAbstract
BACKGROUND: Smoking is the leading preventable cause of premature death in the United States. Previous studies of financial incentives for smoking cessation in work settings have not shown that such incentives have significant effects on cessation rates, but these studies have had limited power, and the incentives used may have been insufficient. METHODS: We randomly assigned 878 employees of a multinational company based in the United States to receive information about smoking-cessation programs (442 employees) or to receive information about programs plus financial incentives (436 employees). The financial incentives were $100 for completion of a smoking-cessation program, $250 for cessation of smoking within 6 months after study enrollment, as confirmed by a biochemical test, and $400 for abstinence for an additional 6 months after the initial cessation, as confirmed by a biochemical test. Individual participants were stratified according to work site, heavy or nonheavy smoking, and income. The primary end point was smoking cessation 9 or 12 months after enrollment, depending on whether initial cessation was reported at 3 or 6 months. Secondary end points were smoking cessation within the first 6 months after enrollment and rates of participation in and completion of smoking-cessation programs. RESULTS: The incentive group had significantly higher rates of smoking cessation than did the information-only group 9 or 12 months after enrollment (14.7% vs. 5.0%, P<0.001) and 15 or 18 months after enrollment (9.4% vs. 3.6%, P<0.001). Incentive-group participants also had significantly higher rates of enrollment in a smoking-cessation program (15.4% vs. 5.4%, P<0.001), completion of a smoking-cessation program (10.8% vs. 2.5%, P<0.001), and smoking cessation within the first 6 months after enrollment (20.9% vs. 11.8%, P<0.001). CONCLUSIONS: In this study of employees of one large company, financial incentives for smoking cessation significantly increased the rates of smoking cessation. (ClinicalTrials.gov number, NCT00128375.)
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Experiments testing financial incentives to improve health behaviors demonstrate that financial incentives can improve health behaviors in the short term, especially when financial incentives are larger.
“These studies demonstrate that financial incentives can improve health behaviors in the short term, especially when financial incentives are larger.216–219”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [218]
Incentives led to greater participation and completion rates, successful cessation in smoking cessation programs at 3 months, and greater weight loss ranging from 0.9 to 2.25 kg at 3 months, but these differences generally did not persist at longer follow-up (e.g., 6 months) after completion of the incentive programs.
“Generally, incentives led to greater participation and completion rates, successful cessation in smoking cessation programs at 3 months, and greater weight loss ranging from 0.9 to 2.25 kg at 3 months. However, these differences generally did not persist at longer follow-up (eg, 6 months) after completion of the incentive programs.”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [218]
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- Authors
- Volpp, K. G., Troxel, A. B., Pauly, M. V., Glick, H. A., Puig, A., Asch, D. A., Galvin, R., Zhu, J., Wan, F., DeGuzman, J., Corbett, E., Weiner, J., & Audrain-McGovern, J.
- Affiliations
- Veterans Health Administration (US)
- Leonard Davis Institute of Health Economics (US)
- Philadelphia VA Medical Center (US)
- General Electric (United States) (US)
- University of Pennsylvania (US)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2009-02-12
- Volume
- 360
- Issue
- 7
- Pages
- 699-709
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2393834324
- Cited by
- 836
- References
- 22
- Citations by year
- 2026: 25 · 2025: 18 · 2024: 33 · 2023: 35 · 2022: 35 · 2021: 48 · 2020: 88 · 2019: 51 · 2018: 62 · 2017: 60 · 2016: 50 · 2015: 76 · 2014: 50 · 2013: 62 · 2012: 54
- FWCI
- 31.02
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pfizer
- Pennsylvania Department of Health
- Centers for Disease Control and Prevention
- National Center for Chronic Disease Prevention and Health Promotion (R01 DP000100-01, R01 DP001168-01)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- smoking cessation, financial incentives, workplace health promotion, smoking cessation interventions, abstinence, multinational company employees
- MeSH terms
- Adult, Female, Follow-Up Studies, Health Promotion, Humans, Male, Middle Aged, Motivation, United States, Program Evaluation, Occupational Health, Smoking Cessation
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