title: A randomized controlled trial of financial incentives for smoking cessation.
abstract: BACKGROUND
  Although 435,000 Americans die each year of tobacco-related illness, only approximately 3% of smokers quit each year. Financial incentives have been shown to be effective in modifying behavior within highly structured settings, such as drug treatment programs, but this has not been shown in treating chronic disease in less structured settings. The objective of this study was to determine whether modest financial incentives increase the rate of smoking cessation program enrollment, completion, and quit rates in a outpatient clinical setting.
  
  
  METHODS
  179 smokers at the Philadelphia Veterans Affairs Medical Center who reported smoking at least 10 cigarettes per day were randomized into incentive and non-incentive groups. Both groups were offered a free five-class smoking cessation program at the Philadelphia Veterans Affairs Medical Center. The incentive group was also offered $20 for each class attended and $100 if they quit smoking 30 days post program completion. Self-reported smoking cessation was confirmed with urine cotinine tests.
  
  
  RESULTS
  The incentive group had higher rates of program enrollment (43.3% versus 20.2%; P<0.001) and completion (25.8% versus 12.2%; P=0.02). Quit rates at 75 days were 16.3% in the incentive group versus 4.6% in the control group (P=0.01). At 6 months, quit rates in the incentive group were not significantly higher (6.5%) than in the control group (4.6%; P>0.20).
  
  
  CONCLUSIONS
  Modest financial incentives are associated with significantly higher rates of smoking cessation program enrollment and completion and short-term quit rates. Future studies should consider including an incentive for longer-term cessation.
authors.affiliation: CHERP, Philadelphia Veterans Affairs Medical Center, University and Woodland Ave., Philadelphia, PA 19104-6021, USA. volpp70@mail.med.upenn.edu
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Volpp
authors.forename: Andrea
authors.initials: A
authors.lastname: Gurmankin Levy
authors.forename: David A
authors.initials: DA
authors.lastname: Asch
authors.forename: Jesse A
authors.initials: JA
authors.lastname: Berlin
authors.forename: John J
authors.initials: JJ
authors.lastname: Murphy
authors.forename: Angela
authors.initials: A
authors.lastname: Gomez
authors.forename: Harold
authors.initials: H
authors.lastname: Sox
authors.forename: Jingsan
authors.initials: J
authors.lastname: Zhu
authors.forename: Caryn
authors.initials: C
authors.lastname: Lerman
mesh_terms: D003367:Cotinine / Q000652:urine; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010349:Patient Compliance; D012201:Reward; D016540:Smoking Cessation / Q000191:economics / Q000379:methods / Q000523:psychology*; D012923:Social Class
chemical_list: D003367:Cotinine