Financial Incentives for Quitting Smoking

(FIESTA II Trial)

Enrolling by invitation at 1 trial location

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, Los Angeles

Disqualifiers: Smokeless tobacco, Pregnant, Institutionalized, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 6 months

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how financial rewards can help people quit smoking, focusing on high-risk smokers in hospitals. It tests three approaches: offering rewards based on goals, outcomes, or enhancing usual care, to determine the most effective method. Researchers aim to identify which approach best helps people quit smoking and improves their quality of life, while also assessing the financial benefits. This trial suits individuals who have smoked in the last 30 days and are considering quitting. As an unphased trial, it offers a unique opportunity to contribute to innovative research that could shape future smoking cessation programs.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It focuses on smoking cessation and financial incentives.

What prior data suggests that financial incentives for smoking cessation are safe?

Research shows that offering money as a reward can help people quit smoking. A 2019 review found that these rewards not only assist in short-term smoking cessation but also maintain smoke-free status after the rewards end. Another study found that financial rewards can increase the number of people who quit and help reduce health disparities between groups.

These findings suggest that financial rewards are generally safe and well-received, as they focus on changing behavior rather than using new drugs or medical procedures. Participants are encouraged to quit smoking with the promise of a reward, avoiding the physical side effects that new medications or treatments might have. For those considering a trial using financial incentives, evidence so far suggests it's a safe way to aid smoking cessation. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores how financial incentives can help people quit smoking, a fresh approach compared to standard options like nicotine replacement therapy or prescription medications such as varenicline and bupropion. These incentives are divided into goal-directed and outcome-based categories, each designed to motivate smokers in unique ways by either rewarding them for reaching specific milestones or for achieving overall cessation success. This method is different because it taps into behavioral economics, offering a potentially powerful complement to existing pharmacotherapy by directly addressing the psychological and motivational aspects of quitting smoking.

What evidence suggests that this trial's treatments could be effective for smoking cessation?

This trial will compare different financial incentive strategies for quitting smoking. Studies have shown that financial incentives can effectively help people quit smoking. A 2019 review found that offering incentives increases long-term quitting rates, even after the incentives stop. Research also indicates that these incentives can boost quitting rates and help reduce health and economic disparities among people. Strong evidence supports that incentives work well in various groups to improve quitting rates over time. Specifically, another study showed that offering financial rewards, such as $100 for completing a program and $250 for quitting within six months, significantly encouraged people to stop smoking. ^{1 2 3 6 7}

Who Is on the Research Team?

Joseph Ladapo, MD, PhD

Principal Investigator

University of California, Los Angeles

Scott Sherman, MD

Principal Investigator

NYU Langone Health

Are You a Good Fit for This Trial?

This trial is for adults over 18 who have smoked tobacco in the last month, are considering quitting smoking, and can consent in English or Spanish. They must have an active U.S. phone number and address. It's not for those using only smokeless tobacco, pregnant or breastfeeding individuals, people discharged to institutions like nursing homes, or anyone unable to consent.

Inclusion Criteria

have an active U.S. phone number and address

I can give my consent in English or Spanish.

You have smoked tobacco within the last month.

Exclusion Criteria

I am being discharged to a nursing home or long-term care facility.

I am able to understand and agree to participate in the study.

You only use smokeless tobacco products.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive financial incentives for smoking cessation interventions

6 months

Follow-up

Participants are monitored for smoking abstinence and quality of life

12 months

Long-term Follow-up

Assessment of long-term return on investment and healthcare utilization

3 years

What Are the Treatments Tested in This Trial?

Interventions

• Financial incentives for smoking cessation
• Financial incentives for use of evidence-based smoking cessation therapies
• Smoking cessation counseling (Quitline)
• Smoking cessation pharmacotherapy

Trial Overview The study tests if financial rewards can help hospitalized smokers quit. Participants will receive smoking cessation counseling (Quitline), pharmacotherapy (like nicotine patches), and cash incentives for quitting or using these therapies effectively.

How Is the Trial Designed?

Group I: Outcome-Based Incentives Experimental Treatment 3 Interventions

Group II: Goal-Directed Incentives Experimental Treatment 3 Interventions

Group III: Enhanced Usual Care Experimental Treatment 2 Interventions

Who Is Running the Clinical Trial?

University of California, Los Angeles

Lead Sponsor

Trials

1,594

Recruited

10,430,000+

NYU Langone Health

Collaborator

Trials

1,431

Recruited

838,000+

Olive View-UCLA Education & Research Institute

Collaborator

Trials

34

Recruited

880,000+

Published Research Related to This Trial

A study involving 3,816 Medicaid beneficiaries found that modest financial incentives significantly improved smoking cessation outcomes, including quit attempts and abstinence rates, compared to usual care.

Participants receiving nicotine patches along with financial incentives were more likely to achieve both short-term (7-day and 30-day) and long-term (6-month) abstinence, demonstrating the effectiveness of integrating financial incentives into smoking cessation programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Incentives and Patches for Medicaid Smokers: An RCT. Anderson, CM., Cummins, SE., Kohatsu, ND., et al.[2019]

In a study involving 8144 participants, varenicline and bupropion were associated with specific adverse events (AEs) like nausea and insomnia compared to the nicotine patch, but overall, these treatments were well tolerated with less than 1.5% of participants experiencing severe AEs.

Most reported AEs were manageable and not clinically significant, allowing healthcare providers to reassure patients about the safety of these smoking cessation pharmacotherapies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Frequently Reported Adverse Events With Smoking Cessation Medications: Post Hoc Analysis of a Randomized Trial. Ebbert, J., Jimenez-Ruiz, C., Dutro, MP., et al.[2021]

In a study involving 35 smokers, those who were more dependent on nicotine (smoking within 5 minutes of waking) required a higher financial incentive to quit, highlighting the varying motivations among smokers.

The use of a willingness-to-accept (WTA) auction led to a 45% quit rate among participants who won the auction, compared to only 20% for those who did not win, suggesting that tailored financial incentives can significantly enhance smoking cessation success.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Going Once, Going Twice: Using Willingness-to-Accept Auctions to Promote Smoking Cessation. Quisenberry, AJ., Shaw, S., Ferketich, AK., et al.[2021]

In a study involving 179 smokers, modest financial incentives significantly increased enrollment (43.3% vs. 20.2%) and completion (25.8% vs. 12.2%) of a smoking cessation program, indicating that financial rewards can effectively motivate participation in such programs.

The incentive group achieved a higher short-term quit rate at 75 days (16.3% vs. 4.6%), but this difference was not maintained at 6 months, suggesting that while incentives can boost initial success, additional strategies may be needed for long-term cessation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized controlled trial of financial incentives for smoking cessation. Volpp, KG., Gurmankin Levy, A., Asch, DA., et al.[2022]

Citations

1. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2820672

Financial Incentives for Smoking Cessation Among ... A 2019 review concluded that offering incentives for smoking cessation improves long-term abstinence rates even after discontinuing incentives.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7293955/

Financial Incentives for Smoking Cessation in Hospitalized ... Financial incentives for smoking cessation and use of evidence-based therapy may increase quitting rates and reduce health and economic disparities.

3. tobaccocontrol.bmj.com tobaccocontrol.bmj.com/content/early/2025/04/22/tc-2024-059198

Financial incentives for smoking cessation among ... We systematically reviewed evidence addressing the barriers and facilitators to successful implementation of incentive-based smoking cessation interventions ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6635501/

Incentives for smoking cessation - PMC - PubMed Central - NIH Overall there is high‐certainty evidence that incentives improve smoking cessation rates at long‐term follow‐up in mixed population studies. The effectiveness ...

5. nejm.org nejm.org/doi/full/10.1056/NEJMsa0806819

A Randomized, Controlled Trial of Financial Incentives for ... The financial incentives were $100 for completion of a smoking-cessation program, $250 for cessation of smoking within 6 months after study ...

6. clinicaltrials.gov clinicaltrials.gov/study/NCT00128375

Study Details | Financial Incentives for Smoking Cessation Enrollment in and completion of community-based smoking cessation programs within the first 6 months after randomization ; Short-term quit rates at 3 months or 6 ...

7. cochranelibrary.com cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004307.pub7/abstract

Incentives for smoking cessation - Notley, C - 2025 Financial incentives (money, vouchers, or self‐deposits) can be used to positively reinforce smoking cessation. They may be used as one‐off ...