Helping Smokers Quit: Payments, Personalized Support Can Work.

Money may be more powerful than nicotine, as a new study led by a School of Public Health researcher found that smokers who received financial incentives, in addition to personalized support, were more successful in quitting than smokers who did not receive these interventions.

Published in JAMA Internal Medicine, the study demonstrates that these approaches could play an important role in helping people cease tobacco use. Despite declining smoking rates in recent years, tobacco use is still the leading cause of preventable death in the US, disproportionately affecting minorities and people of low socioeconomic status (SES).

“Our results show that a successful intervention to help low-SES individuals quit smoking should be multifaceted and focus on both assisting with resources and, when possible, providing financial incentives,” said lead author Karen E. Lasser, associate professor of community health sciences, associate professor of medicine at the School of Medicine, and general internist at Boston Medical Center.

Researchers from BMC developed an intervention that connected participants with a patient navigator who could assist them in getting prescriptions for nicotine replacement therapies and refer them to counseling resources. The study also provided financial incentives for quitting. Those who quit at 6 months received $250, plus an additional $500 if they were not smoking at 12 months. Those who did not quit at 6 months were given a second chance to earn $250 if they quit at 12 months. Participants were not told in advance how much money they could receive by quitting.

Those in the control group received informational materials about resources to help them quit smoking.

Participants who reported quitting had their saliva or urine tested to biologically confirm smoking cessation at the 6- and 12-month marks. After 6 months, nearly 10 percent of the intervention group had quit smoking, while less than 1 percent in control group had quit; after 12 months, 12 percent of the intervention group quit smoking, while 2 percent of the control group had quit. The intervention was found to be especially beneficial for older participants, women, and non-white smokers.

While most of the patients who ended up quitting utilized patient navigation, Lasser said it was unclear whether navigation alone would have achieved the same rates of cessation.

The study was supported by the American Cancer Society.