title: Effectiveness of a small cash incentive on abstinence and use of cessation aids for adult smokers: A randomized controlled trial.
abstract: Large amount of financial incentive was effective to increase tobacco abstinence, but the effect of small amount is unknown.
  
  
  
  We evaluated if a small amount of cash incentive (HK$500/US$64) increased abstinence, quit attempt, and use of cessation aids.
  
  
  
  A three-armed, block randomized controlled trial recruited 1143 adult daily smokers who participated in the Hong Kong "Quit to Win" Contest. Biochemically validated quitters of the early-informed (n=379, notified about the incentive at 1-week and 1-month follow-up) and the late-informed incentive group (n=385, notified at 3-month follow-up) received the incentive at 3months. The validated quitters of the control group (n=379) received the incentive at 6months without prior notification. All subjects received brief advice, a self-help education card and a 12-page booklet. The outcomes were self-reported 7-day point prevalence of abstinence, quit attempt (intentional abstinence for at least 24h) and use of cessation aids at 3-month follow-up.
  
  
  
  By intention-to-treat, the early-informed group at 3-month follow-up reported a higher rate of quit attempt (no smoking for at least 24h) than the other 2 groups (44.1% vs. 37.4%, Odds ratio (OR)=1.32, 95% CI 1.03-1.69, p=0.03), but they had similar abstinence (9.2% vs. 9.7%, OR=0.95, 95% CI 0.62, 1.45). The early- and late-informed group showed similar quitting outcomes. The early-informed group reported more quit attempts by reading self-help materials than the other 2 groups (31.4% vs. 25.3%, OR=1.56, 95% CI 1.12-2.18, p<0.01).
  
  
  
  The small cash incentive with early notification increased quit attempt by "self-directed help" but not abstinence. Future financial incentive-based programmes with a larger incentive, accessible quitting resources and encouragement of using existing smoking cessation services are needed.
authors.affiliation: School of Public Health, The University of Hong Kong, Hong Kong; School of Nursing, The University of Hong Kong, Hong Kong. Electronic address: derekcheung@hku.hk.
authors.forename: Yee Tak Derek
authors.initials: YT
authors.lastname: Cheung
authors.affiliation: School of Nursing, The University of Hong Kong, Hong Kong.
authors.forename: Man Ping
authors.initials: MP
authors.lastname: Wang
authors.affiliation: School of Nursing, The University of Hong Kong, Hong Kong.
authors.forename: Ho Cheung William
authors.initials: HC
authors.lastname: Li
authors.affiliation: Hong Kong Council on Smoking and Health, Hong Kong.
authors.forename: Antonio
authors.initials: A
authors.lastname: Kwong
authors.affiliation: Hong Kong Council on Smoking and Health, Hong Kong.
authors.forename: Vienna
authors.initials: V
authors.lastname: Lai
authors.affiliation: School of Nursing, The University of Hong Kong, Hong Kong.
authors.forename: Sophia Siu Chee
authors.initials: SS
authors.lastname: Chan
authors.affiliation: School of Public Health, The University of Hong Kong, Hong Kong.
authors.forename: Tai-Hing
authors.initials: TH
authors.lastname: Lam
mesh_terms: D000328:Adult; D017668:Age of Onset; D000073863:Cigar Smoking / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D009042:Motivation; D010174:Pamphlets; D010353:Patient Education as Topic; D012907:Smoking / Q000523:psychology; D016540:Smoking Cessation / Q000191:economics / Q000379:methods*; D000074606:Smoking Prevention / Q000191:economics / Q000379:methods*; D012959:Socioeconomic Factors; D062789:Tobacco Products / Q000706:statistics & numerical data; D061485:Tobacco Use Cessation Devices / Q000706:statistics & numerical data*; D016896:Treatment Outcome
keywords: Addiction; Cessation; Health services; Incentive