31 May is World No Tobacco Day - read the latest Cochrane evidence indicating that incentive programmes may help smokers to quit for six months or more
Financial and material incentives are widely used to encourage smokers to try to quit, and to reward them if they succeed. Examples of incentives include lottery tickets or prize draws, cash payments, vouchers for goods and groceries, and the return of money deposited by those taking part. Such schemes can be run in workplaces, in clinics, and sometimes as community programmes.
A team of Cochrane authors based in United Kingdom worked with Cochrane Tobacco Addition Group to determine whether incentives and contingency management programmes lead to higher long-term quit rates of smoking.
Twenty-one mixed-population trials with more than 8400 participants were included. All the trials followed up their participants for at least six months, and checked whether or not the quitters had succeeded by testing their breath or bodily fluids. Six months or more after the beginning of the trial, people receiving incentives were more likely to have quit than those in the control groups. Only three trials reported prolonged success beyond the close of the programme.
Incentive schemes conducted among pregnant smokers improved the cessation rates, both at the end-of-pregnancy and post-partum assessments. “Until the most recent trials, it appeared that incentives tended to boost smoking quit rates only while they were in place, but the large USA trials have thrown this into question. However, these high-reward programmes may only be feasible in cultures where cessation support programmes already operate as part of a public health policy. Deposit-refund trials can suffer from relatively low rates of uptake, but those smokers who do sign up and contribute their own money may achieve higher quit rates than reward-only participants” said Kate Cahill, a research at the University of Oxford in the United Kingdom and lead author of the Cochrane Review. “It’s important that future research investigates a variety of possible incentive programmes, with varied reward mechanisms and in a range of smoking populations.”
Special Collection: World No Tobacco Day 2015