Small Financial Incentives Reap Big Rewards to Help People Quit Smoking

Low-income smokers who received modest payments to quit smoking not only were 57% more likely to quit—but the cost per quitter turned out to be less than for those who didn’t receive those incentives.

According to a new paper in the American Journal of Preventive Medicine, Medicaid smokers in a research study who received up to $190 to adhere to treatments and be abstinent from smoking quit at a rate of 22%, while those who didn’t receive that level of monetary incentive quit at a rate of 14%.

Because significantly more people quit in the incentive group, researchers found that the cost per patient who quit smoking was $660 less than the cost per quitter in the control group.

The results come from a research study called Striving to Quit offered by the University of Wisconsin Center for Tobacco Research and Intervention (UW-CTRI) and the state of Wisconsin, which received a five-year, $9.2 million grant from the federal Centers for Medicare and Medicaid Services to help Medicaid recipients quit smoking. The project, called Striving to Quit, focused on linking adult BadgerCare Plus (Medicaid) members to the Wisconsin Tobacco Quit Line. Participants received up to five proactive coaching calls (plus additional calls initiated by the participant) and medication to quit smoking (covered by Medicaid).

All participants received payment for completing a baseline assessment and a six-month smoking test to confirm they had quit. Participants who received the higher incentives for taking counseling calls ($30 per call) and for biochemically verified abstinence from smoking at the six-month visit ($40) fared better.

“This study demonstrates that fairly moderate levels of incentive payments increased very low-income smokers’ engagement and success in smoking-cessation treatment,” said Dave Fraser, lead author and UW-CTRI Associate Director for Research Administration.

Some participants were homeless during the study yet cut down or quit, as demonstrated in this video.

These results have the potential to have a wide population-health impact, Fraser said, since low-income people smoke at markedly higher rates than the general population, and most prior efforts to reach that population have had less impact.

The grant existed from September 2011 through September 2016, and UW-CTRI Research Director Dr. Tim Baker served as Principal Investigator.