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A new study finds it pays to pay people to stop lighting up: Smokers were more likely to quit if they had an opportunity to gain rewards worth $600 than if they simply received free cessation aids or free e-cigarettes.
The wide majority of the more than 6,000 smokers in the randomized study didn’t quit despite offers of various incentives. All the same, “programs that offered financial incentives tripled the rates of smoking cessation, reduced employers’ costs per successful quit, as compared with programs that offered cessation aids alone, and yielded total costs that compared favorably with the costs of employing smokers,” the study authors wrote.
The researchers reached out to employees and spouses at 54 companies that use wellness programs provided by the Vitality Institute, which supports research into health promotion. The institute provided grant support for the study.
Just over 6,000 employees and spouses who smoked were assigned to five groups. One group received usual care. The others received interventions: free smoking-cessation aids (nicotine replacement therapy, bupropion, or varenicline); free e-cigarettes; up to $600 worth of an unidentified “reward incentive” plus free cessation aids; and up to $600 via a redeemable deposit, plus free cessation aids.
Participants could only get the entire reward incentive or the full $600 redeemable deposit if they showed signs of sustained smoking cessation via blood or urine test at 1, 3, and 6 months.
The median age in the groups ranged from 43 to 45 years, and most were not college graduates. Just over half were women, and roughly 90% said they wanted to quit smoking.
Overall, 20% of the 6,006 participants logged onto the trial website, a sign that they were “engaged.” The number was highest in the free e-cigarette and reward groups (21%-23%) and lowest in the usual care group (16%).
The researchers focused on how many participants abstained from smoking – as confirmed by blood or urine test – for 6 months past the target quit date. The test data confirmed that just 1.3% of the total participants, 80 people, sustained cessation over 6 months.
Only 0.1% of the usual-care group sustained smoking cessation, and the number wasn’t much higher (0.5%) in the free cessation aids group.
One percent of those in the free e-cigarette group sustained cessation. However, the researchers noted there wasn’t a significant difference in the quit rates between the usual care, free cessation aid, and free e-cigarette groups.
“The observation of greater e-cigarette use in the free e-cigarette group than in the free cessation aids group, coupled with the absence of benefit of free e-cigarettes versus no intervention, supports the conclusion that offering free e-cigarettes does not promote smoking cessation,” they cautioned.
In the reward incentive and $600 redeemable-deposit groups, 2% and 2.9% of participants quit over a sustained period, respectively. Cessation rates in the $600 deposit group were superior to the free cessation aid group (P less than .001) and the free e-cigarette group (P = .008). Cessation rates in the incentive group were superior to those in the free cessation aid group (P = .006).
“Average costs per participant assigned to each intervention were lowest in the usual-care group ($0.82) and highest in the redeemable-deposit group ($100.96),” the researchers reported. “The overall cost of each program per participant who was abstinent for 6 months was lower in the rewards and redeemable-deposit groups than in the free e-cigarettes or free cessation aids groups.”
The study received grant support from the Vitality Institute. Most of the study authors reported no relevant disclosures. One author reported serving on the scientific advisory board of VAL Health, and another reported various grants and personal fees.
SOURCE: Halpern SD et al. N Engl J Med. 2018 May 23. doi: 10.1056/NEJMsa1715757.
A new study finds it pays to pay people to stop lighting up: Smokers were more likely to quit if they had an opportunity to gain rewards worth $600 than if they simply received free cessation aids or free e-cigarettes.
The wide majority of the more than 6,000 smokers in the randomized study didn’t quit despite offers of various incentives. All the same, “programs that offered financial incentives tripled the rates of smoking cessation, reduced employers’ costs per successful quit, as compared with programs that offered cessation aids alone, and yielded total costs that compared favorably with the costs of employing smokers,” the study authors wrote.
The researchers reached out to employees and spouses at 54 companies that use wellness programs provided by the Vitality Institute, which supports research into health promotion. The institute provided grant support for the study.
Just over 6,000 employees and spouses who smoked were assigned to five groups. One group received usual care. The others received interventions: free smoking-cessation aids (nicotine replacement therapy, bupropion, or varenicline); free e-cigarettes; up to $600 worth of an unidentified “reward incentive” plus free cessation aids; and up to $600 via a redeemable deposit, plus free cessation aids.
Participants could only get the entire reward incentive or the full $600 redeemable deposit if they showed signs of sustained smoking cessation via blood or urine test at 1, 3, and 6 months.
The median age in the groups ranged from 43 to 45 years, and most were not college graduates. Just over half were women, and roughly 90% said they wanted to quit smoking.
Overall, 20% of the 6,006 participants logged onto the trial website, a sign that they were “engaged.” The number was highest in the free e-cigarette and reward groups (21%-23%) and lowest in the usual care group (16%).
The researchers focused on how many participants abstained from smoking – as confirmed by blood or urine test – for 6 months past the target quit date. The test data confirmed that just 1.3% of the total participants, 80 people, sustained cessation over 6 months.
Only 0.1% of the usual-care group sustained smoking cessation, and the number wasn’t much higher (0.5%) in the free cessation aids group.
One percent of those in the free e-cigarette group sustained cessation. However, the researchers noted there wasn’t a significant difference in the quit rates between the usual care, free cessation aid, and free e-cigarette groups.
“The observation of greater e-cigarette use in the free e-cigarette group than in the free cessation aids group, coupled with the absence of benefit of free e-cigarettes versus no intervention, supports the conclusion that offering free e-cigarettes does not promote smoking cessation,” they cautioned.
In the reward incentive and $600 redeemable-deposit groups, 2% and 2.9% of participants quit over a sustained period, respectively. Cessation rates in the $600 deposit group were superior to the free cessation aid group (P less than .001) and the free e-cigarette group (P = .008). Cessation rates in the incentive group were superior to those in the free cessation aid group (P = .006).
“Average costs per participant assigned to each intervention were lowest in the usual-care group ($0.82) and highest in the redeemable-deposit group ($100.96),” the researchers reported. “The overall cost of each program per participant who was abstinent for 6 months was lower in the rewards and redeemable-deposit groups than in the free e-cigarettes or free cessation aids groups.”
The study received grant support from the Vitality Institute. Most of the study authors reported no relevant disclosures. One author reported serving on the scientific advisory board of VAL Health, and another reported various grants and personal fees.
SOURCE: Halpern SD et al. N Engl J Med. 2018 May 23. doi: 10.1056/NEJMsa1715757.
A new study finds it pays to pay people to stop lighting up: Smokers were more likely to quit if they had an opportunity to gain rewards worth $600 than if they simply received free cessation aids or free e-cigarettes.
The wide majority of the more than 6,000 smokers in the randomized study didn’t quit despite offers of various incentives. All the same, “programs that offered financial incentives tripled the rates of smoking cessation, reduced employers’ costs per successful quit, as compared with programs that offered cessation aids alone, and yielded total costs that compared favorably with the costs of employing smokers,” the study authors wrote.
The researchers reached out to employees and spouses at 54 companies that use wellness programs provided by the Vitality Institute, which supports research into health promotion. The institute provided grant support for the study.
Just over 6,000 employees and spouses who smoked were assigned to five groups. One group received usual care. The others received interventions: free smoking-cessation aids (nicotine replacement therapy, bupropion, or varenicline); free e-cigarettes; up to $600 worth of an unidentified “reward incentive” plus free cessation aids; and up to $600 via a redeemable deposit, plus free cessation aids.
Participants could only get the entire reward incentive or the full $600 redeemable deposit if they showed signs of sustained smoking cessation via blood or urine test at 1, 3, and 6 months.
The median age in the groups ranged from 43 to 45 years, and most were not college graduates. Just over half were women, and roughly 90% said they wanted to quit smoking.
Overall, 20% of the 6,006 participants logged onto the trial website, a sign that they were “engaged.” The number was highest in the free e-cigarette and reward groups (21%-23%) and lowest in the usual care group (16%).
The researchers focused on how many participants abstained from smoking – as confirmed by blood or urine test – for 6 months past the target quit date. The test data confirmed that just 1.3% of the total participants, 80 people, sustained cessation over 6 months.
Only 0.1% of the usual-care group sustained smoking cessation, and the number wasn’t much higher (0.5%) in the free cessation aids group.
One percent of those in the free e-cigarette group sustained cessation. However, the researchers noted there wasn’t a significant difference in the quit rates between the usual care, free cessation aid, and free e-cigarette groups.
“The observation of greater e-cigarette use in the free e-cigarette group than in the free cessation aids group, coupled with the absence of benefit of free e-cigarettes versus no intervention, supports the conclusion that offering free e-cigarettes does not promote smoking cessation,” they cautioned.
In the reward incentive and $600 redeemable-deposit groups, 2% and 2.9% of participants quit over a sustained period, respectively. Cessation rates in the $600 deposit group were superior to the free cessation aid group (P less than .001) and the free e-cigarette group (P = .008). Cessation rates in the incentive group were superior to those in the free cessation aid group (P = .006).
“Average costs per participant assigned to each intervention were lowest in the usual-care group ($0.82) and highest in the redeemable-deposit group ($100.96),” the researchers reported. “The overall cost of each program per participant who was abstinent for 6 months was lower in the rewards and redeemable-deposit groups than in the free e-cigarettes or free cessation aids groups.”
The study received grant support from the Vitality Institute. Most of the study authors reported no relevant disclosures. One author reported serving on the scientific advisory board of VAL Health, and another reported various grants and personal fees.
SOURCE: Halpern SD et al. N Engl J Med. 2018 May 23. doi: 10.1056/NEJMsa1715757.
FROM NEW ENGLAND JOURNAL OF MEDICINE
Key clinical point: Smokers are more likely to sustain cessation if they receive incentives worth $600.
Major finding: Cessation rates for 6 months past target quit date reached as high as 2.9% in smokers who had the opportunity to gain rewards, while they didn’t top 1% in those who received free cessation aids or free e-cigarettes.
Study details: A randomized, prospective study of 6,006 smokers (employees of 54 companies and spouses) who were assigned to usual care or one of four intervention groups.
Disclosures: The study received grant support from the Vitality Institute. Most of the study authors reported no relevant disclosures. One reported serving on the scientific advisory board of VAL Health, and another reported various grants and personal fees.
Source: Halpern SD et al. N Engl J Med. 2018 May 23. doi: 10.1056/NEJMsa1715757.