People who are paid to stop smoking are about three times more likely to quit and not have another cigarette than those given no cash, a study found.
Almost 15 percent of study participants who were given money as a reward were still not smoking six months after quitting compared with 5 percent in the group that didn’t get the cash incentive, research in this week’s New England Journal of Medicine found. Some people in both groups eventually started smoking again after the financial offers ended.
Smoking is the top cause of preventable death in the U.S., responsible for killing about 438,000 people each year, according to the study. Getting one person to stop smoking can save businesses about $3,400 a year by boosting productivity, decreasing absenteeism and reducing illnesses, according to estimates from the Centers for Disease Control and Prevention.
“Employers are already paying for the cost of smoking,” said the study’s lead author Kevin Volpp, director of the Center for Health Incentives at the University of Pennsylvania in Philadelphia, in a Feb. 10 telephone interview. “Rather than paying for the consequences, why not try to use some of that money to help motivate people so that they don’t develop smoking- related illnesses in the first place?”
Smoking can cause lung cancer, lung disease, heart disease, stroke and cataracts, according to the National Institutes of Health. About one in five U.S. adults, or 45.3 million, smoked in 2006, according to the Atlanta-based CDC. The percentage figure remained constant since 2004 after a previous seven-year decline in smoking among U.S. adults, the CDC said.
GE Employees
Robert Galvin, chief medical officer for Fairfield, Connecticut-based General Electric Co., said the company participated in the study to help determine if incentives would encourage people to stop smoking, which would lower health-care costs. GE spends about $50 million each year on health care for smokers, a figure that doesn’t include the cost of lost productivity, he said. GE, the biggest maker of jet engines and the owner of the NBC-Universal media unit, employs about 152,000 people in the U.S.
“We are very excited about the fact that we have proved that incentives can work to help stop smoking,” said Galvin, who is also an author on the paper.
The study included 878 people who worked at GE in the U.S. Of those, 436 employees were given information about smoking- cessation programs along with an offer of cash incentives and 442 were only provided information about the programs, without money.
Money for Quitting
Those in the financial incentives group received $100 for completing the smoking-cessation program, $250 for not smoking within six months after enrolling in the study and $400 for abstinence after six months more, confirmed by saliva or urine tests. The trial was designed to see how many people remained nonsmokers nine or 12 months after enrolling in the study, depending on whether they initially stopped smoking within three months or six months of participating.
After an additional six months, 9.4 percent of the paid group still wasn’t smoking though they were no longer receiving cash rewards, compared with 3.6 percent of the other group.
“There’s a lot of room for further intervention,” Volpp said. “If we could encourage broader adoption of these programs, that would go a long way to improve cessation rates.”
About 70 percent of those who smoke in the U.S. say they want to quit, but only 2 percent to 3 percent succeed each year, the researchers said. Most relapses occur within the first month of quitting and about 90 percent of those who start smoking again do so within the first six months, according to the authors.
Rewards for Healthy Behavior
The study was supported by the U.S. Centers for Disease Control and Prevention and the Pennsylvania Department of Health. Volpp reported owning equity in GE.
A study by Volpp in December in the Journal of the American Medical Association also found that people who were paid to lose weight dropped 13 to 14 pounds on average after 16 weeks, compared with a loss of 3.9 pounds by those who didn’t get the cash incentive.
“There’s something very powerful about the awards being paid to you using other people’s money. That’s very motivating,” Volpp said. Providing people with money gives them a reward in the present rather than waiting for a future reward like better health.