Patient Focus | A study conducted by researchers at the University of Pennsylvania and published in the New England Journal of Medicine compared four different employment-based smoking cessation programs that reward individuals for quitting smoking. Many employers, including CVS and General Electric, already offer programs to help their employees quit. Not only can these programs improve employee health and productivity, they may reduce company payouts to insurance companies. The question is: What’s the best type of smoking cessation program that employers can offer?

To learn more, researchers assigned more than 2,500 CVS employees to a variety of smoking cessation programs in 2012. Two programs simply rewarded smokers up to $800 for not smoking, while two others required a $150 deposit, which could be recouped only if smokers successfully quit. Each type of program had either an individual or group model, to see if one design worked better than the other. Some studies suggest that group programs make individuals more accountable, which could be useful when it comes to quitting smoking. Some participants were also assigned to standard education and counseling on smoking cessation, which offered no cash incentives.

After following participants for six months, researchers found that quit rates were much higher among those in cash incentive programs versus standard programming. Only 6% of smokers in the standard care group successfully quit after 6 months, compared to 9–16% of adults in the cash incentive programs. There was no difference in quit rates between the individual and group programs, suggesting that a sense of peer pressure or competition doesn’t increase smokers’ chances of quitting.

Interestingly, researchers also noted that subjects were much less likely to enroll in a smoking cessation program that requires a deposit. Of those assigned to the reward-based programs, 90% enrolled into the program. In comparison, only 14% of those assigned to the deposit-based programs actually enrolled.

Overall, findings suggest that adding cash incentives to smoking cessation programs drastically increases smokers’ chances of quitting. However, rewards-based programs are much more appealing than deposit-based programs, which require smokers to risk their own money. This study suggests that adults are hesitant to put up their own money as part of a deposit program, especially when they risk losing it if they don’t successfully quit. Since deposits may create a barrier to enrollment, rewards-based programs may be the best way for employers to help smokers kick the habit and improve their health.

Keywords: CardioSource WorldNews, ACC Publications, Occupational Health, Smoking Cessation

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