Cash Incentive Helps Smokers Quit
> 2/24/2009 1:48:36 PM

In an attempt to relieve America’s overburdened healthcare system, President Obama signed a law that will more than double the Federal Cigarette Tax starting April 1st. The American Lung Association excitedly released estimates of the good that this tax would achieve, predicting that in New York alone it will “help 41,300 adult smokers to quit.” While it is certain that the tax will generate substantial income to fund healthcare programs, studies on the power of economic incentives to facilitate quitting have been ambiguous. The issue is cleared up substantially by a new study on an employee incentive program, published this February in the New England Journal of Medicine.

One of the reasons that previous studies may have failed to detect significant benefits of incentives is that they often offered paltry rewards or followed too few subjects. To avoid these deficiencies, Dr. Kevin Volpp set up an extensive incentive program at General Electric where the reward could reach as high as $750. The study divided participants into a control group that got only information about cessation programs, and an experimental group that got financial rewards as well as information.

The 436 participants in the incentive group were offered escalating rewards, beginning at $100 for completing a smoking-cessation program, growing to a $250 reward for cessation of smoking, and culminating in a $400 reward for staying abstinent six months after originally quitting. Abstinence was confirmed with biochemical tests to rule out the possibility of deceptive reporting.

The incentive group had a significantly higher percentage of participants who were abstinent one year after beginning the study, 14.7% compared to the 5% of the control group. General Electric's chief medical officer, Dr. Robert Galvin, was so impressed by the results that he committed to a company-wide program with the expectation that the expenditure would pay for itself within five years.

When health and economic goals align, great things can get done. This study inspires optimism in incentive programs for smoking cessation because it was done in the real world instead of a clinical setting, observed hundreds of diverse participants, and offered substantial rewards. A threefold increase in cessation rate should be a good enough incentive for other companies and governments to institute their own incentive plans.

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