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Effects of Large Financial Incentives for Long-Term Smoking Cessation: A Randomized Trial.
J Am Coll Cardiol. 2016 08 23; 68(8):777-85.JACC

Abstract

BACKGROUND

It is not known whether large financial incentives enhance long-term smoking cessation rates outside clinical or workplace settings.

OBJECTIVES

The goal of this study was to test whether large financial incentives improved long-term smoking cessation rates in low-income smokers, in a general population setting, without face-to-face or telephone counseling.

METHODS

This was a 2-arm, parallel group, individually randomized controlled trial, with follow-up after 3, 6, and 18 months. Participants were 805 low-income smokers enrolled between 2011 and 2013 from the general population in Geneva, Switzerland. We randomly assigned participants to receive either booklets plus access to a smoking cessation website (control group, n = 404), or the same intervention plus financial incentives (intervention group, n = 401). Incremental financial rewards, to a maximum of U.S. $1,650, were offered for biochemically verified abstinence at 1, 2, and 3 weeks, and 1, 3, and 6 months. No in-person counseling, telephone counseling, or medications were provided. The primary outcome was continuous abstinence between 6 months (end of incentives) and 18 months (12 months after the incentives ended), verified by expired carbon monoxide and salivary cotinine. We also assessed biochemically verified 7-day abstinence at 3, 6, and 18 months.

RESULTS

Rates of continuous abstinence between months 6 and 18 were 9.5% in the incentive group and 3.7% in the control group (p = 0.001). Rates of 7-day abstinence were higher in the incentive group than in the control group at 3 (54.9% vs. 11.9%; p < 0.001), 6 (44.6% vs. 11.1%; p < 0.001), and 18 months (18.2% vs. 11.4%; p = 0.006).

CONCLUSIONS

In low-income smokers who did not receive face-to-face or telephone smoking cessation counseling, large financial incentives increased long-term rates of smoking cessation. (Financial incentives for smoking cessation in low-income smokers; ISRCTN04019434).

Authors+Show Affiliations

Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland. Electronic address: jean-francois.etter@unige.ch.Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27539168

Citation

Etter, Jean-François, and Felicia Schmid. "Effects of Large Financial Incentives for Long-Term Smoking Cessation: a Randomized Trial." Journal of the American College of Cardiology, vol. 68, no. 8, 2016, pp. 777-85.
Etter JF, Schmid F. Effects of Large Financial Incentives for Long-Term Smoking Cessation: A Randomized Trial. J Am Coll Cardiol. 2016;68(8):777-85.
Etter, J. F., & Schmid, F. (2016). Effects of Large Financial Incentives for Long-Term Smoking Cessation: A Randomized Trial. Journal of the American College of Cardiology, 68(8), 777-85. https://doi.org/10.1016/j.jacc.2016.04.066
Etter JF, Schmid F. Effects of Large Financial Incentives for Long-Term Smoking Cessation: a Randomized Trial. J Am Coll Cardiol. 2016 08 23;68(8):777-85. PubMed PMID: 27539168.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of Large Financial Incentives for Long-Term Smoking Cessation: A Randomized Trial. AU - Etter,Jean-François, AU - Schmid,Felicia, PY - 2015/12/22/received PY - 2016/03/30/revised PY - 2016/04/10/accepted PY - 2016/8/20/entrez PY - 2016/8/20/pubmed PY - 2017/7/1/medline KW - contingency management KW - financial incentives KW - nicotine KW - tobacco use disorder SP - 777 EP - 85 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 68 IS - 8 N2 - BACKGROUND: It is not known whether large financial incentives enhance long-term smoking cessation rates outside clinical or workplace settings. OBJECTIVES: The goal of this study was to test whether large financial incentives improved long-term smoking cessation rates in low-income smokers, in a general population setting, without face-to-face or telephone counseling. METHODS: This was a 2-arm, parallel group, individually randomized controlled trial, with follow-up after 3, 6, and 18 months. Participants were 805 low-income smokers enrolled between 2011 and 2013 from the general population in Geneva, Switzerland. We randomly assigned participants to receive either booklets plus access to a smoking cessation website (control group, n = 404), or the same intervention plus financial incentives (intervention group, n = 401). Incremental financial rewards, to a maximum of U.S. $1,650, were offered for biochemically verified abstinence at 1, 2, and 3 weeks, and 1, 3, and 6 months. No in-person counseling, telephone counseling, or medications were provided. The primary outcome was continuous abstinence between 6 months (end of incentives) and 18 months (12 months after the incentives ended), verified by expired carbon monoxide and salivary cotinine. We also assessed biochemically verified 7-day abstinence at 3, 6, and 18 months. RESULTS: Rates of continuous abstinence between months 6 and 18 were 9.5% in the incentive group and 3.7% in the control group (p = 0.001). Rates of 7-day abstinence were higher in the incentive group than in the control group at 3 (54.9% vs. 11.9%; p < 0.001), 6 (44.6% vs. 11.1%; p < 0.001), and 18 months (18.2% vs. 11.4%; p = 0.006). CONCLUSIONS: In low-income smokers who did not receive face-to-face or telephone smoking cessation counseling, large financial incentives increased long-term rates of smoking cessation. (Financial incentives for smoking cessation in low-income smokers; ISRCTN04019434). SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/27539168/Effects_of_Large_Financial_Incentives_for_Long_Term_Smoking_Cessation:_A_Randomized_Trial_ DB - PRIME DP - Unbound Medicine ER -