Cash rewards better than e-cigarettes at helping smokers quit

Cash incentives are three times more effective to help smokers kick the butt than smoking cessation aids, such as nicotine patches, chewing gums or e-cigarettes, a study has found.

Many corporate wellness programmes offer free smoking cessation aids to help employees quit smoking.

However, researchers from the University of Pennsylvania in the US showed that merely offering such aids for free does not help employees quit, whereas supplementing them with financial incentives is three times more effective.

The study, published in the New England Journal of Medicine, provides the first large-scale evidence that offering e-cigarettes to known smokers is not effective at helping smokers stay smoke-free.

"Smoking remains the leading cause of preventable deaths in the US, and nearly all large employers offer wellness programmes aimed at getting people to quit," said Scott D Halpern, an associate professor at University of Pennsylvania in the US.

"But, these programmes vary considerably, and to date, there has been little evidence to suggest which designs and strategies are most effective," said Halpern.

"The new study drives forward previous research by showing that even among smokers who are not cherry picked on the basis of their motivation to quit, financial incentives still triple quit rates, whereas offering free conventional cessation aids or free e-cigarettes accomplishes nothing at all," he said.

The study enrolled more than 6,000 participants from across 54 US-based companies. Participants were assigned to one of four smoking cessation intervention groups or usual care - consisting of access to information regarding the benefits of quitting smoking and a motivational text-messaging service.

Smoking cessation interventions included usual care plus one of the following: free e-cigarettes; free cessation aids - nicotine patches, gum, and other medications; free cessation aids plus USD 600 in rewards for sustained abstinence from smoking; or free cessation aids plus USD 600 in redeemable funds, which were deposited in an account for each participant and removed if smoking cessation milestones were not met.

The study found that overall, only 1.3 per cent of participants remained smoke-free for at least six months.

However, the quit rates for redeemable deposits were significantly higher than with free cessation aids or with free e-cigarettes, and the quit rate for the rewards group was also higher than for cessation aids.

By contrast, no differences were found in the quit rates among participants assigned to free e-cigarettes, free cessation aids, or usual care.

"The result is concerning because it suggests that e-cigarettes may do more harm than good," Halpern said.