Financial incentives for abstinence among socioeconomically disadvantaged individuals in smoking cessation treatment

Am J Public Health. 2015 Jun;105(6):1198-205. doi: 10.2105/AJPH.2014.302102. Epub 2014 Nov 13.


Objectives: We evaluated the effectiveness of offering adjunctive financial incentives for abstinence (contingency management [CM]) within a safety net hospital smoking cessation program.

Methods: We randomized participants (n = 146) from a Dallas County, Texas, Tobacco Cessation Clinic from 2011 to 2013 to usual care (UC; cessation program; n = 71) or CM (UC + 4 weeks of financial incentives; n = 75), and followed from 1 week before the quit date through 4 weeks after the quit date. A subset (n = 128) was asked to attend a visit 12 weeks after the scheduled quit date.

Results: Participants were primarily Black (62.3%) or White (28.1%) and female (57.5%). Most participants were uninsured (52.1%) and had an annual household income of less than $12 000 (55.5%). Abstinence rates were significantly higher for those assigned to CM than UC at all visits following the quit date (all Ps < .05). Point prevalence abstinence rates in the CM and UC groups were 49.3% versus 25.4% at 4 weeks after the quit date and 32.8% versus 14.1% at 12 weeks after the quit date. CM participants earned an average of $63.40 ($150 possible) for abstinence during the first 4 weeks after the scheduled quit date.

Conclusions: Offering small financial incentives for abstinence might be an effective means to improve abstinence rates among socioeconomically disadvantaged individuals participating in smoking cessation treatment.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Demography
  • Female
  • Health Literacy
  • Humans
  • Male
  • Middle Aged
  • Smoking Cessation / economics*
  • Socioeconomic Factors
  • Texas
  • Token Economy*
  • Treatment Outcome