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Randomized Controlled Trial
. 2022 Aug 31;19(17):10879.
doi: 10.3390/ijerph191710879.

Smoking Cessation Programs Are Less Effective in Smokers with Low Socioeconomic Status Even When Financial Incentives for Quitting Smoking Are Offered-A Community-Randomized Smoking Cessation Trial in Denmark

Charlotta Pisinger  1   2   3 , Cecilie Goltermann Toxværd  2 , Mette Rasmussen  4   5
Affiliations
Randomized Controlled Trial

Smoking Cessation Programs Are Less Effective in Smokers with Low Socioeconomic Status Even When Financial Incentives for Quitting Smoking Are Offered-A Community-Randomized Smoking Cessation Trial in Denmark

Charlotta Pisinger et al. Int J Environ Res Public Health. .

Abstract

Financial incentives offered to those who quit smoking have been found effective, also in persons with low socioeconomic status (SES), but no previous study has investigated who benefits most: smokers with low or high SES. In this community-randomized trial ("Richer without smoking"), three Danish municipalities were randomized to reward persons who were abstinent when attending the municipal smoking cessation program (FIMs) and three municipalities were randomized to spend the same amount on smoking cessation campaigns recruiting smokers to the smoking cessation program (CAMs). The municipalities each received approximately USD 16,000. An intention-to-treat approach was used in analyses. In regression analyses adjusted for individual- and municipal-level differences, we found that smokers with high SES living in FIMs had significantly higher proportion of validated long-term successful quitters (OR (95% CI): 2.59 (1.6-4.2)) than high-SES smokers living in CAM. Smokers with low SES, however, did not experience the same benefit of financial incentives as smokers with high SES. Neither the FIMs nor the CAMs succeeded in attracting more smokers with low SES during the intervention year 2018 than the year before. Our study showed that smokers with low SES did not experience the same benefit of financial incentives as smokers with high SES.

Keywords: financial incentives; smoking cessation; socioeconomic status.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure A1
Figure A1
A graphical presentation of the timing and frequency of the meetings in the gold standard smoking cessation intervention used in both the financial incentives municipalities (FIM) and the campaign municipalities (CAM), and of the timing and amount of the rewards used in the FIM only.
Figure A2
Figure A2
Abstinence rates from smoking in the “Richer without smoking” study, based on a complete case approach; Denmark, 2018. Validated abstinence rates at the end of the intervention (4–6 weeks), after 12+-months, and self-reported abstinence rates after 6 months. FIM: financial in-centive municipality, CAM: campaign municipality, SES: socioeconomic status.
Figure 1
Figure 1
Flowchart of the allocation of municipalities and recruitment and follow-up status of smokers included in the community-randomized trial “Richer without smoking”, Denmark.
Figure 2
Figure 2
Abstinence rates from smoking in the “Richer without smoking” study, based on the intention-to-treat principle; Denmark, 2018. Validated abstinence rates at the end of the intervention (4–6 weeks), after 12+-months, and self-reported abstinence rates after 6 months. FIM: financial incentive municipality, CAM: campaign municipality, SES: socioeconomic status.
See this image and copyright information in PMC

References

    1. GBD 2019 Tobacco Collaborators Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: A systematic analysis from the Global Burden of Disease Study 2019. Lancet. 2021;397:2337–2360. doi: 10.1016/S0140-6736(21)01169-7. - DOI - PMC - PubMed
    1. Zhou X., Vohs K.D., Baumeister R.F. The symbolic power of money: Reminders of money alter social distress and physical pain. Psychol. Sci. 2009;20:700–706. doi: 10.1111/j.1467-9280.2009.02353.x. - DOI - PubMed
    1. Notley C., Gentry S., Livingstone-Banks J., Bauld L., Perera R., Hartmann-Boyce J. Incentives for smoking cessation. Cochrane Database Syst. Rev. 2019;7:Cd004307. doi: 10.1002/14651858.CD004307.pub6. - DOI - PMC - PubMed
    1. Pisinger C., Toxværd C.G., Rasmussen M. Are financial incentives more effective than health campaigns to quit smoking? A community-randomised smoking cessation trial in Denmark. Prev. Med. 2022;154:106865. doi: 10.1016/j.ypmed.2021.106865. - DOI - PubMed
    1. Prochaska J.J., Das S., Young-Wolff K.C. Smoking, Mental Illness, and Public Health. Annu. Rev. Public Health. 2017;38:165–185. doi: 10.1146/annurev-publhealth-031816-044618. - DOI - PMC - PubMed

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