Key Takeaways
Financial incentives can help smokers quitSmokers have up to a 54% better chance of quitting if they’re offered rewardsPregnant smokers are more than twice as likely to quit
WEDNESDAY, Jan. 15, 2025 (HealthDay News) — Smokers are better able to quit if they’re offered financial incentives for their efforts.
Overall, smokers had up to a 54% better chance at kicking the habit if their quit program offered them cash or vouchers as a reward, researchers found in a new evidence review published Jan. 13 in the Cochrane Database of Systematic Reviews.
These incentives made even more of an impression on pregnant smokers, who were more than twice as likely to quit long-term if provided rewards, the review says.
“Smoking is the leading preventable cause of ill health and early death worldwide, and quitting smoking is vitally important to help people live in good health for longer,” lead researcher Caitlin Notley, professor of addiction sciences at University of East Anglia’s Norwich Medical School, said in a news release.
“We are now very confident that incentives help people, and pregnant people too, to quit smoking better than not offering incentives,” Notley added.
Up to now, the evidence regarding financial incentives for quitting smoking hasn’t been solid, researchers noted.
But an evaluation of 47 previous studies, including 14 newer papers, “found high-certainty evidence this time that indeed they help people who are pregnant quit smoking and stay quit,” senior researcher Jamie Hartmann-Boyce, assistant professor of health policy and promotion with the University of Massachusetts Amherst School of Public Health and Health Sciences, said in a news release from the college.
“We know that smoking while pregnant can be really harmful to both the parent and the fetus,” Hartmann-Boyce said. “And people are more cautious in pregnancy about using a lot of the pharmacological interventions that are approved for smoking cessation. So that’s why we’re focused on ways that we can help pregnant people quit smoking.”
For the review, researchers pooled previous research involving nearly 22,000 total participants.
This approach — offering rewards to help people fight addiction — is part of a model called “contingency management,” researchers said. The incentives essentially use positive reinforcement to help a person modify their behavior.
The studies varied widely in terms of the financial incentives provided. Some required people to reward themselves by depositing money in an account, while others offered incentives worth between $45 and nearly $1,200.
Overall, these incentives work, researchers concluded.
About 10 out of every 100 smokers who receive financial incentives are able to remain smoke-free for six months or longer, compared with 7 out of 100 who didn’t receive rewards as part of their quit program, results show.
Pregnant women do even better with incentives, with 13 out of 100 smoke-free for six month or longer compared with 6 in 100 not offered rewards, the review found.
Evidence remains unclear how much incentive is best for motivating smokers.
“We did not have enough evidence to find out if offering different value rewards had an impact on smoking cessation,” the researchers wrote.
California is the first state to offer financial incentives to help people battle addiction, Hartmann-Boyce noted. There, people are offered small-value gift cards and other rewards via Medicaid to quit using drugs like methamphetamine and cocaine.
Since California received federal approval in 2021 to take this approach, 14 more states have followed suit, she said.
“A lot of people have an aversion to the idea of making payments available to people who use substances – precisely because they use those substances,” Hartmann-Boyce said. “But it would benefit all of us if more people were able to quit smoking.”
“The other common misperception around financial incentives is this idea that, oh, all these people are able to quit smoking, and they just weren’t because they weren’t going to get paid,” Hartmann-Boyce added. “Actually, there’s a lot of evidence to suggest that this intervention is acting on the psychological reward systems in the brain, which we know are heavily involved with nicotine addiction.”
“So, it’s not that these people could have quit anyway and then were paid and decided to do so,” she continued. “A lot of people in these studies have tried to quit many times, they really want to quit and weren’t able to do so, and this helped them.”
More information
Case Western Reserve University has more about contingency management.
SOURCE: University of Massachusetts Amherst, news release, Jan. 12, 2025
What This Means For You
People who want to quit smoking should look into support programs that offer rewards.
