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Money Helps: Financial Incentives for Smoking Cessation Among People Experiencing Homelessness.

Dian Gu1,2, Jordan Cuby3, Omar Gomez3

  • 1UCSF Division of General Internal Medicine, University of California, San Francisco, San Francisco, California, USA.

Substance Use & Misuse
|June 5, 2026
PubMed
Summary

Financial incentives significantly boosted smoking cessation among homeless individuals by reinforcing motivation and self-efficacy. This study highlights the positive impact of contingency management on improving health and quality of life for this vulnerable population.

Keywords:
Smoking cessationcontingency managementpeople experiencing homelessness

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Published on: August 28, 2017

Area of Science:

  • Public Health
  • Behavioral Science
  • Addiction Medicine

Background:

  • Over 70% of individuals experiencing homelessness are current cigarette smokers.
  • Smoking cessation interventions are crucial for this population, often facing co-occurring mental health and substance use disorders.

Purpose of the Study:

  • To evaluate an extended (6-month) contingency management (CM) intervention for smoking cessation in adults experiencing homelessness.
  • To explore participants' experiences and perspectives on smoking cessation within a primary care setting.

Main Methods:

  • A randomized controlled trial comparing escalating gift card incentives (CM group) with fixed incentives for attendance (control group).
  • In-depth interviews with 31 participants at one-year follow-up, analyzed thematically and mapped to Social Cognitive Theory constructs.

Main Results:

  • Financial incentives were reported to reinforce smoking cessation and support daily expenses.
  • Incentives enhanced motivation and self-efficacy for quitting, increasing behavioral capability.
  • Observational learning from peers and family, alongside positive outcome expectancies (improved health, quality of life), supported cessation.

Conclusions:

  • Homeless individuals perceived financial incentives as effective in reinforcing smoking cessation.
  • Contingency management interventions can improve quality of life for those experiencing homelessness by supporting cessation efforts.