Venue: The Fuqua School of Business, Duke University, 1 Towerview Drive, Durham, NC 27708-0120
Presentation
A Randomized Controlled Trial of Financial Incentives for Smoking Cessation
Introduction: Although 70% of smokers report wanting to quit, only about 3% of smokers successfully do so each year. Previous efforts to test the effectiveness of financial incentives for smoking cessation in the workplace have generally used incentives of small magnitude and have been underpowered. In partnership with General Electric (GE), we designed a testable financial incentives intervention that could be broadly utilized by employers if effective in increasing smoking cessation rates.
Purpose/Objective: To determine the effectiveness of financial incentives for smoking cessation
Methods: 878 subjects were enrolled in a controlled trial, in which subjects were randomized to receive either information about smoking cessation programs within 20 miles of their workplace or the same information plus a package of financial incentives worth $750. The randomization was stratified by worksite, income, and degree of nicotine dependence. Intervention arm participants received $100 for completing a smoking cessation program, $250 for quitting smoking anytime in the first 6 months of study enrollment, and $400 for continuous abstinence between the 6 month and 12 month follow-up visits. Self-reported cessation was regarded as valid only if confirmed by a negative cotinine test.
Results: During the first 6 months following study enrollment, 9.4% of the incentive group completed a smoking cessation program vs. 0.9% of the control group (p-value<0.0001). Quit rates in the first 6 months were significantly higher in the incentive group compared to the control group (20.9% vs 11.8%, p-value=0.0003). At 12 months, quit rates were 14.9% in the incentive group vs. 4.8% in the control group (p-value<0.0001). This means that the relapse rates among smokers who quit smoking in the first 6 months were significantly lower in the incentive than the control group (28.6% vs 59.6%, p-value = 0.0003). Follow-up of study participants for an additional 6 months to determine relapse rates following cessation of incentive payments is ongoing.
Conclusions: Financial incentives for smoking cessation could have a significant impact on increasing tobacco cessation rates in the United States population.