The team writes: “Smoking is the leading cause of preventable death and disease worldwide. Most adults who smoke wish to quit, but quitting is challenging and despite the presence of effective evidence-based cessation methods, quit rates remain low. Quitting smoking can lead to substantial health gains, even later in life. The earlier someone quits smoking, the more they reduce their risk of developing smoking-related diseases.”
“Incentives and rewards routinely feature in smoking cessation programmes. Theory suggests they might work according to behavioural processes of operant conditioning (positively rewarding the desired behaviour), or by providing short-term gain for behaviour change that ultimately results in long-term gain, but is perceived as less proximal to the individual (delay discounting) (Gneezy 2011; Miglin 2017).”
“Incentives can be used to encourage recruitment into the programme, to reward compliance with the process, and to reward cessation achieved at predefined stages, usually contingent on production of a biochemically-con- firmed cessation outcome. A variety of rewards have been used for these purposes, including cash payments, vouchers exchangeable for goods (excluding alcohol and cigarettes) or leisure activities, salary bonuses, or promotional items such as T-shirts, pens and bags.”
The team looked at 33 trials from eight countries, this covered more than 21,000 smokers. Ten of the trials had focused pregnant women who smoked.
Dr Caitlin Notley, University of East Anglia, said: “In comparison to the total amount that the NHS has to set aside in the UK for smoking-related diseases, the cost of providing incentives is incredibly small in comparison.”
“Incentives support people in the early stages of trying to quit smoking, which are the most difficult, and once people have made that health behaviour change and the incentives are removed, they’re more likely to stay abstinent from smoking in the longer term,” added the study’s lead author.
She added that it was important to provide a range of options to smokers, which includes vaping.
Top experts on ITV’s Loose Women commented on the findings. Nadia Sawalha (Mirror, Signal, Manoeuvre and Celebrity Big Brother) said that although she gave up while pregnant she didn’t think anything would help her quit permanently. Carol McGiffin (Pointless and Celebrity Big Brother) stated that quitting is possible through willpower.
Chief executive of the British Lung Foundation Dr Penny Woods said: “Offering financial incentives to help people quit smoking has been dismissed in the past, so it’s fantastic to see strong evidence that these innovative schemes work. Local authorities should consider this new research when designing comprehensive stop smoking services, as it could help target those in our communities who struggle the most to give up cigarettes.”
- “Incentives for smoking cessation” by Notley, Gentry, Livingstone‐Banks, Bauld, Perera, and Hartmann‐Boyce – [link]