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Incentives for smoking cessation.

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Financial incentives can increase smoking cessation rates, particularly for pregnant smokers. Deposit-refund schemes and substantial cash payments show promise for sustained success, though uptake can be a challenge.

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Area of Science:

  • Behavioral Science
  • Public Health
  • Addiction Medicine

Background:

  • Financial incentives are utilized to promote behavior change, including smoking cessation, across various settings like workplaces and clinics.
  • This review specifically includes trials involving pregnant smokers, a high-risk group, due to increased targeted interventions.

Purpose of the Study:

  • To evaluate the effectiveness of incentives and contingency management programs in achieving higher long-term smoking cessation rates.

Main Methods:

  • Conducted a systematic review of randomized controlled trials and controlled studies involving individuals, workplaces, groups, and communities.
  • Included studies in mixed-population settings and trials specifically in pregnant smokers, with data collection and analysis performed by two authors.
  • Primary outcome was smoking abstinence at longest follow-up (≥6 months for mixed populations, ≥ pregnancy end for pregnant smokers).

Main Results:

  • Twenty-one mixed-population studies (8400+ participants) showed an overall odds ratio (OR) of 1.42 for quitting with incentives.
  • Incentives improved cessation rates in pregnant smokers (OR 3.60), with contingent rewards demonstrating clear benefits.
  • Deposit-refund trials showed higher quit rates among participants, despite lower uptake, while rewards-based interventions varied in sustained success.

Conclusions:

  • Incentives effectively boost smoking cessation rates while active; sustained success may depend on substantial cash payments or deposit-refund schemes.
  • Incentive schemes significantly improved cessation rates for pregnant smokers, both during pregnancy and post-partum.
  • Future research should explore optimal incentive structures (scale, loading, longevity) across diverse smoking populations.