Paying Smokers to Quit Really Works

A new analysis shows financial rewards are effective.

Posted Jul 22, 2019

ivanchik29/Adobe Stock
Source: ivanchik29/Adobe Stock

Smoking is bad for you—that’s common knowledge. Tobacco use is the leading cause of preventable disease, disability, and death in the United States, according to the U.S. Centers for Disease Control.

But quitting smoking is difficult because the nicotine in cigarettes is so addictive. Data show nearly 40 million U.S. adults still smoke cigarettes, and about 4.7 million middle and high school students use at least one nicotine product, including e-cigarettes.

As a result, researchers and healthcare providers are constantly looking for new and better ways to help people quit smoking. A new systematic review demonstrates a concept that is proven to work: Paying smokers to quit.

The review, published in the Cochrane Database of Systematic Reviews, includes 33 studies with more than 21,600 participants in total. The studies were conducted in the U.S., Europe, Thailand, and the Philippines in a wide range of settings including community centers, workplaces, health clinics, and outpatient drug clinics.

Each study offered some type of financial incentive for quitting smoking—including self-deposits (meaning the participants paid themselves for quitting), vouchers for goods, or cash. The total dollar amount ranged from $45 to $700. The studies followed participants for at least six months to make sure they did not start smoking again and tested the breath and bodily fluids for evidence of smoking.

Researchers found people who received rewards were significantly more likely to have stopped smoking than those who received no payment. Of the people who received incentives, approximately 10.5 percent successfully quit smoking, compared to 7 percent of people who did not receive incentives. While these numbers may seem small, it is important to note that quitting smoking is difficult and often requires many attempts.

The review data also demonstrated that people were less likely to start smoking again, even when the incentives were finished. And it didn’t seem to matter how much participants were paid; those paid the lowest amounts were just as likely to quit smoking as those who received more money.

The financial costs of smoking are high—not to mention the detrimental effects to the smoker’s quality of life and possible effects of secondary smoke on others. In the U.S. alone, illnesses related to smoking cost more than $300 billion each year, including $170 billion in direct medical costs.

The bottom line: Given the high costs of smoking, it makes sense to help people quit by offering financial rewards—especially because they appear to be effective.

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