HealthDay News – Financial incentives may boost smoking cessation rates, according to a study published in the August 23 issue of the Journal of the American College of Cardiology.1

The study involved 805 low-income smokers who wanted to quit smoking. They were randomly assigned to receive no pay or payments that increased incrementally for confirmed abstinence. On average, individuals had an annual income of about $20,000 and smoked about 16 cigarettes a day. Forty-three percent were students and 19 percent were unemployed. They all received instructional booklets and access to a website with information about quitting. They were periodically tested to verify whether or not they were smoking.

Although many individuals resumed smoking and 81 dropped out (mostly those not paid), the researchers found a significant number who were paid to quit succeeded. Three months after the pay-to-quit program started, 44.4% of smokers who received money said they had been abstinent continuously, compared with 6.4% of those not paid. 6 months, 35.9% of the paid group still hadn’t smoked, compared with 5.7% of the others. At 18 months, 1 in 10 (9.5%) who received money still weren’t smoking vs 3.7% of those who weren’t paid.

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Judith Prochaska, PhD, MPH, an associate professor of medicine at the Stanford University Medical School in California, coauthor of an accompanying journal editorial,2 pointed out the 6 percentage point difference between paid and unpaid groups after 18 months. Seventeen people would need to go through an incentive program to get one to quit, she told HealthDay, adding it would cost $28,000 to get one additional smoker to succeed long term. Despite the cost, payments may be a productive alternative for certain smokers. “Paying smokers to quit has been found to increase quitting, at least in the short-term,” Prochaska said.


  1. Etter J-F, Schmid F. Effects of large financial incentives for long-term smoking cessation: a randomized trial. J Am Coll Cardiol. 2016;68(8):777-785. doi:10.1016/j.jacc.2016.04.066.
  2. Ladapo J, Prochaska JJ. Paying smokers to quit. Does it work? Should we do it? J Am Coll Cardiol. 2016;68(8):786-788. doi:10.1016/j.jacc.2016.04.067.