NEJM Published Research from Vitality Group & University of Pennsylvania Shows Monetary Incentives Stronger than Other Aids in Getting People to Quit Smoking


The New England Journal of Medicine published a study yesterday finding that smoking cessation aids such as patches, gum or e-cigarettes offered for free in corporate wellness programs are not particularly effective in getting employees to quit. Financial incentives fared best in doing so.

The study looked at 6,000 participants across 54 US-based companies and was led by researchers at the Perelman School of Medicine at the University of Pennsylvania and Vitality Group. This offered the first large-scale evidence that providing e-cigarettes to smokers is ineffective in getting smokers to quit and the bigger behavioral impact came from those who received money for quitting smoking. This study stands apart from other smoking cessation studies in that it was aimed at smokers in the workplace at large rather than just those who had indicated interest in trying to quit.

“Getting people to quit smoking is extraordinarily difficult,” said Christine Brophy, Director of Research and Development for Vitality Group and a study author. “The impact of e-cigarettes, patches and gums as smoking cessation tool in the workplace had not previously been tested and we wanted to confirm that our focus on properly implemented incentives is effective in improving health behaviors.”

Participants were assigned to one of four smoking cessation intervention groups that included usual care plus one of the following: free e-cigarettes; free cessation aids (nicotine patches, gum, and other medications, with free e-cigarettes only available for participants who’ve tried standard therapies previously); free cessation aids plus $600 in rewards for sustained abstinence from smoking; or free cessation aids plus $600 in redeemable funds, which were deposited in an account for each participant and removed if smoking cessation milestones were not met.

“Smoking remains the leading cause of preventable deaths in the United States, and smokers cost employers an average of $3,000-6,000 more per year over non-smokers,” said lead author Scott D. Halpern, MD, PhD, an associate professor of Medicine, Epidemiology at the Perelman School of Medicine at the University of Pennsylvania, and a member of the Steering Committee of the Penn Center for Health Incentives and Behavioral Economics. “Finding interventions that appeal to smokers is key. This study found even among smokers who are not cherry picked based on their motivation to quit, financial incentives still triple quit rates, whereas offering free conventional cessation aids or free e-cigarettes accomplishes very little.”

The study found the quit rates for the redeemable deposits group were five times higher than those that received free cessation aids or with free e-cigarettes, and the quit rate for the rewards group was 3.5 times more effective than offering free smoking cessation tools.

“At face value, giving cash to get people to quit smoking may seem an expensive undertaking for employers, but this study confirms that it’s more cost-effective than the other alternatives,” said Brophy.

Sam C., one of the study participants noted, “I have wanted to do this for my son, but I couldn’t do it alone. The motivations and support tools provided by this program helped me quit for good. It is just my son and I and he deserves a dad who is going to be alive for as long as possible.”

Vitality Group sponsored and participated in this study as part of its commitment to ensure its program use the latest behavioral science strategies paired with the right incentives, right science and the right technology to help people achieve optimal health.

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