Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 17;24(10):1661-1668.
doi: 10.1093/ntr/ntac042.

Design of Financial Incentive Programs for Smoking Cessation: A Discrete Choice Experiment

Rachel J Breen  1 , Matthew A Palmer  1 , Mai Frandsen  1 , Stuart G Ferguson  1
Affiliations

Design of Financial Incentive Programs for Smoking Cessation: A Discrete Choice Experiment

Rachel J Breen et al. Nicotine Tob Res. .

Abstract

Introduction: Financial incentive programs promote smoking cessation. However, the incentive amount which should be provided-and how this may interact with other program characteristics-is unknown. The objective of this study was to evaluate the influence of the design of incentive programs for smoking cessation on current smokers' perceptions of programs and willingness to enroll.

Method: An online discrete choice experiment was conducted amongst adult current smokers residing in the United Kingdom (N = 430). Hypothetical incentive programs were described using five attributes (incentive amount, incentive type, frequency of sessions, reward schedules, program location). Participants responded to a series of choice sets comprised of two hypothetical programs. For each set, participants selected their preferred program. They then specified whether they would enroll in their preferred program if it were available. Analyses also considered the effect of participant income on preferences.

Results: Overall, participants preferred higher amounts over lower amounts, cash over vouchers, healthcare settings over workplaces, and consistent amounts over an escalating schedule. One session per week was the most preferred session frequency. Willingness to enroll increased quadratically with the incentive amount, although this increase slowed for higher amounts. Although middle- and high-income smokers preferred slightly higher amounts (cf. low-income participants), enrollment choices did not differ by income.

Conclusion: The characteristics of incentive programs influence smokers' perceptions of programs and willingness to enroll. Higher amounts may encourage greater enrollment rates, but there will likely be a ceiling point beyond which increasing the incentive amount does not meaningfully increase enrollments.

Implications: There is increasing evidence incentive programs aid smoking cessation. Yet, the variety in previous program designs means how to best structure programs, including optimal incentive amount and the impact of the design on potential enrollment rates, remains unclear. This study suggests enrollments may be highest when incentive amounts are higher, rewards of a consistent amount in cash are provided, and sessions occur once per week in a healthcare setting. Although higher-income participants may desire higher incentive amounts compared to lower-income participants, this may not translate into differences in willingness to enroll.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Example choice set.
Figure 2.
Figure 2.
Predicted program uptake across incentive amounts.
See this image and copyright information in PMC

References

    1. Jha P, Ramasundarahettige C, Landsman V, et al. . 21st-century hazards of smoking and benefits of cessation in the United States. N Engl J Med. 2013;368(4):341–350. - PubMed
    1. Gakidou E, Afshin A, Abajobir AA, et al. . Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1345–1422. - PMC - PubMed
    1. Borland R, Partos TR, Yong H-H, Cummings KM, Hyland A. How much unsuccessful quitting activity is going on among adult smokers? Data from the International Tobacco Control Four Country cohort survey. Addiction. 2012;107(3):673–682. - PMC - PubMed
    1. Babb S, Malarcher A, Schauer G, Asman K, Jamal A. Quitting smoking among adults – United States, 2000–2015. CDC- Morbilty Mortal Wkly Rep. 2017;65(52):1457–1464. - PubMed
    1. Australian Institute of Health and Welfare. The National Drug Strategy Household Survey 2016: Detailed Findings. Australian Institute of Health and Welfare; 2017. https://www.aihw.gov.au/getmedia/15db8c15-7062-4cde-bfa4-3c2079f30af3/21...

Publication types