The best incentive to quit smoking? Free money.
The best way to get people to quit smoking is to offer them cash, a new study suggests.
Research published Wednesday in the New England Journal of Medicine compared the effectiveness of different programs for getting people to quit. They divided more than 6,000 participants into several groups.
Some were offered advice on smoking cessation and access to a motivational text-messaging service. Some also got free cessation aids, like nicotine patches. Another group got that, plus free e-cigarettes. And two groups got all those things, plus $600 – either immediately with the caveat that it gets taken back if they start smoking again, or as a reward after they successfully stopped smoking for six months.
The two groups who were offered cash saw a significant jump in their success rates after six months – about double that of the e-cigarette group.
“People do respond to monetary rewards,” said Dr. Andrew Pipe, a smoking cessation researcher at the Ottawa Heart Institute and professor of medicine at the University of Ottawa.
Most smokers know that they shouldn’t smoke and express interest in quitting, he said, but often just telling them about decreased life expectancy and diseases isn’t enough.
“The approaches to kind of scare the living daylights out of smokers are really not necessary. What smokers will value is offers of assistance.”
Other studies that have looked at money as an incentive have also seen quite a bit of success, he said.
“I guess it really speaks to people’s interest in outcomes that are how we say, more tangible.”
This study overall found lower rates of successful quitting than most studies on smoking cessation, according to the paper. Just 2.9 per cent of people who were given the “redeemable deposit” option – where the $600 could be taken away – actually quit.
But the study’s authors and Pipe think that this was more likely to do with how smokers were recruited than the actual effectiveness of the program. Essentially, 6,131 people were invited to enroll and asked to opt out if they didn’t participate. Only a tiny fraction of people responded to opt out, so that left a lot of people who may not have actively participated.
Among people who were engaged with the study, 12.7 per cent of people who were given the “redeemable deposit” were smoke-free after six months.
Pipe thinks that this cash incentive approach will become more common. “If we really want to make substantial changes, say in smoking cessation, we’ve got to be pretty innovative in terms of the way we deliver those services.”
But the money has to come from somewhere. Pipe believes a “polluter pay” taxation scheme could be a possible solution. “We’ve got to start making the tobacco industry pay for the carnage that they produce as a consequence of deliberately addicting people to nicotine.”
According to Statistics Canada, 17 per cent of Canadians aged 12 and older smoked in 2016.
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