Cash rewards up to $600 helped medically underserved individuals successfully quit smoking, according to a study published in JAMA.
RT’s Three Key Takeaways:
- Financial Incentives Double Cessation: Offering cash rewards of up to $600 nearly doubled smoking cessation rates among medically underserved adults undergoing lung cancer screening, according to a clinical trial published in JAMA.
- Reaching Underserved Populations: The study evaluated more than 3,200 individuals who actively smoke tobacco, focusing on lower-income, rural, Black, and Hispanic patients who traditionally encounter barriers to healthcare.
- Biochemically Verified Results: Participants earned tiered payments contingent on confirming tobacco abstinence through blood or urine laboratory tests across six months.
Offering financial incentives of up to $600 nearly doubled smoking cessation rates among medically underserved adults undergoing lung cancer screening, according to a randomized clinical trial published in JAMA and announced by Penn Medicine.
The trial enrolled more than 3,200 patients who actively smoke tobacco and were referred for low-dose computed tomography (CT) lung cancer screening. Participating health systems included Penn Medicine, Geisinger, Henry Ford Health, and Kaiser Permanente Southern California.
Annual lung cancer screening is recommended for adults aged 50 to 80 years who have at least a 20 pack-year smoking history and currently smoke or have quit within the past 15 years, the researchers noted. Study participants were predominantly from populations that encounter persistent barriers to high-quality healthcare, including individuals with lower incomes, residents of rural communities, and Black and Hispanic adults.
“These participants had smoked for decades and likely made multiple unsuccessful quit attempts in the past. We found that adding financial incentives increased quit rates in a population that can be especially difficult to reach with traditional smoking cessation approaches,” said Scott D Halpern, MD, PhD, director of the Palliative and Advanced Illness Research (PAIR) Center at Penn.
Also read: Smartphone-based Financial Incentives to Help Pregnant Women Quit Smoking
Evaluating Cessation Strategies
Tobacco use remains the leading cause of preventable illness and death globally, accounting for an estimated 450,000 deaths in the US each year, according to the study authors.
To address this challenge, researchers evaluated four cessation approaches: standard ask-advise-refer care connecting patients to community or health-system resources; standard care paired with free smoking cessation medications; standard care with free medications and financial incentives; and that same package combined with FutureMe, a text-based behavioral tool that encouraged participants to visualize their future smoke-free lives.
The trial demonstrated that financial rewards produced higher abstinence rates compared with usual care and free medications alone, according to the report. Enrolled participants could earn up to $600 through a structured series of payments contingent on biological verification: $100 at two weeks, $200 at three months, and $300 at six months, confirmed via blood or urine testing.
Implications for Clinical Care
The researchers reported that the project represents the largest trial to assess financial incentives for smoking cessation among patients referred for lung cancer screening, as well as one of the largest conducted within medically underserved groups.
“Finding new approaches that help people successfully stop smoking can have an enormous impact, not only on their health but also on their quality of life,” said lead author Joanna L Hart, MD, an assistant professor in pulmonary, allergy, and critical care at Perelman School of Medicine at the University of Pennsylvania.
According to the investigators, subsequent work will explore strategies to implement incentive-based cessation models across wider health systems while examining public perceptions surrounding financial incentives for smoking cessation.
