Incentives Aid Smoking Cessation Across Populations
By Lori Solomon HealthDay Reporter
TUESDAY, Jan. 14, 2025 -- There is high-certainty evidence that incentives improve smoking cessation rates at long-term follow-up across populations, according to a review published online Jan. 13 in the Cochrane Database of Systematic Reviews.
Caitlin Notley, Ph.D., from Norwich Medical School at the University of East Anglia in the United Kingdom, and colleagues conducted a systematic review to assess the long-term effects of incentives and contingency management programs for smoking cessation in mixed and pregnant populations. Incentives included cash payments, self-deposits, or vouchers for goods and groceries, offered directly or collected and redeemable online.
Based on 48 mixed-population studies that allocated 21,924 participants to smoking cessation incentive schemes or control conditions, the researchers found that the pooled risk ratio (RR) for quitting with incentives at the longest follow-up (six months or longer) was 1.52 (I2 = 23 percent; 39 studies, 18,303 participants; high-certainty evidence) compared with controls. Results were similar when excluding seven studies that offered an incentive for cessation at long-term follow-up (RR, 1.46; I2 = 26 percent; 32 studies, 15,082 participants), suggesting the impact of incentives continues for at least some time after incentives cease. Total financial amount of incentives varied considerably between trials, from zero (self-deposits) to a range from $45 to $1,185, but there was no clear difference in effect between trials offering low or high total value of incentives nor those encouraging redeemable self-deposits. In an analysis including 14 studies of 4,314 pregnant people, pooled data showed an RR at the longest follow-up (up to 48 weeks postpartum) of 2.13 (I2 = 31 percent; 13 studies, 3,942 participants; high-certainty evidence), in favor of incentives.
"It's not that these people could have quit anyway and then were paid and decided to do so," coauthor Jamie Hartmann-Boyce, Ph.D., from the University of Massachusetts Amherst, said in a statement. "A lot of people in these studies have tried to quit many times, they really want to quit and weren't able to do so, and this helped them."
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Posted January 2025
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