Incentive programmes for smoking cessation: cluster randomized trial in workplaces in Thailand

Area of Science:

• Public Health
• Behavioral Science
• Occupational Health

Background:

• Workplace smoking remains a significant public health issue, particularly in middle-income countries.
• Effective, scalable interventions are needed to promote smoking abstinence among employees.
• Monetary incentives show promise but require optimized design for maximum impact.

Purpose of the Study:

• To compare the effectiveness of various monetary incentive programs for promoting smoking abstinence in a workplace setting.
• To identify specific incentive design components that enhance long-term smoking cessation.
• To evaluate the feasibility and acceptance of these programs in a low-resource environment.

Main Methods:

• A cluster randomized controlled trial involving 4172 employees from 101 worksite clusters in Bangkok, Thailand.
• Eight different incentive programs were compared against usual care (group counseling and text messaging support).
• Incentive designs varied by refundable deposits, team assignments, and bonus amounts ($20 or $40), with outcomes assessed at 3, 6, and 12 months.

Main Results:

• Program acceptance was high (58.7% overall).
• The $40 individual bonus program demonstrated the highest efficacy for 12-month smoking abstinence (16.5% vs. 12.4% for no bonus).
• Team-based and deposit-based programs showed less significant long-term abstinence compared to individual-based and non-deposit designs.

Conclusions:

• Monetary incentive programs are acceptable and can be effective for promoting smoking abstinence in workplace settings.
• The design of incentives is crucial, with larger individual bonuses showing greater long-term success.
• Optimized incentive strategies can enhance workplace wellness programs and reduce smoking rates in resource-limited areas.