Workers Paid To Quit Smoking

Featured Article
Main Category: Smoking / Quit Smoking
Article Date: 12 Feb 2009 - 1:00 PDT

email to a friend   printer friendly   view / write opinions

Researchers found that paying workers in a large US company to quit smoking was more successful than just giving them information about the benefits of quitting, as reflected in higher rates of enrollment in and completion of cessation programs, and managing to quit within 6 months of joining the study.

The study was the work of lead author Kevin G Volpp from the Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, in the University of Pennsylvania, and researchers from other parts of the US, and is published online in the 12 February issue of the New England Journal of Medicine, NEJM.

Smoking is the leading preventable cause of early death in the US. The authors wrote that previous studies looking at the effect of financial incentives had not shown promising results, but these could have been due to insufficient incentives and insufficient numbers in the studies.

For this study, the researchers recruited 878 participants, all employees of the multinational General Electric company working in 85 sites across the United States, and randomly assigned them to one of two groups.

One group (442 workers) received information about giving up smoking, and the other group (436 workers) got the same information plus financial incentives comprising 100 dollars if they completed a smoking cessation program, 250 dollars if they quit within 6 months of enrolling in the study, and 400 dollars if they abstained from smoking for another 6 months.

The workers also underwent biochemical tests to confirm their reported smoking status; it was not just down to what they said.

The researchers also noted other data about the participants, such as their work site, type of work (heavy or non heavy), how much they smoked and their income.

The main outcome measure was smoking cessation at 9 or 12 months after enrolling in the study, depending on whether they stopped smoking at 3 or 6 months. The secondary outcome measures were smoking cessation within 6 months of enrolling in the study, and the numbers who took part in and completed the cessation programs.

The results showed that:

• At 9 or 12 months after joining the study, the group that was paid to quit (the incentive group) had significantly higher rates of smoking cessation than the group that only received educational materials (14.7 vs 5.0 per cent respectively, P<0.001).


• At 15 or 18 months after study enrollment, the gap was still there (9.4 vs 3.6 per cent, P<0.001).


• The incentive group also had significantly higher rates of enrollment (15.4 vs 5.4 per cent, P<0.001) and completion of a smoking-cessation program (10.8 vs 2.5 per cent, P<0.001).


• The incentive group also had a higher rate of quitting smoking within the first 6 months after joining the study compared with the group that just received educational materials (20.9 vs 11.8 per cent, P<0.001).

The authors concluded that:

"In this study of employees of one large company, financial incentives for smoking cessation significantly increased the rates of smoking cessation."

Commenting on the study, Volpp told Reuters news agency that incentive programs only work if they have enough financial backing and are well designed; low budget ones will have little effect.

"Our study shows that if you're able to get people smoke-free and keep them smoke-free for six months or more, there's a fighting chance they can stay smoke-free on their own," said Volpp in a phone interview.

According to Reuters, nearly all the participants in this study were highly educated white volunteers, and one can't say if the findings apply to other groups or whether the results would be different for different sizes of incentive.

"A Randomized, Controlled Trial of Financial Incentives for Smoking Cessation."
Volpp, Kevin G., Troxel, Andrea B., Pauly, Mark V., Glick, Henry A., Puig, Andrea, Asch, David A., Galvin, Robert, Zhu, Jingsan, Wan, Fei, DeGuzman, Jill, Corbett, Elizabeth, Weiner, Janet, Audrain-McGovern, Janet.
N Engl J Med Volume 360, Number 7, pp 699-709, February 12, 2009

Click here for Abstract.

Sources: NEJM, Reuters.

Written by: Catharine Paddock, PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today