Financial Incentives for Quitting Smoking

(FIESTA II Trial)

Recruiting 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

1058 Participants Needed

Trial Summary

What is the purpose of this trial?

Financial incentives for motivating changes in health behavior, particularly for smoking and other morbid habits, are increasingly being tested by health insurers, employers, and government agencies. However, in using incentive programs for smoking cessation, key unanswered structural and theoretical questions remain regarding their effectiveness, acceptability to patients, and economic sustainability. This trial aims to advance the science and implementation of financial incentives for smoking cessation interventions among high-risk, hospitalized smokers. The investigators will pursue two specific aims: 1) comparing the impact of three approaches for smoking cessation on smoking abstinence, use of evidenced-based therapy, and quality of life and 2) comparing the short-term and long term return on investment of using goal directed and outcome-based financial incentives to promote smoking cessation.

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 data supports the effectiveness of the treatment Financial incentives for quitting smoking?

Research shows that financial incentives can help people quit smoking by increasing their engagement in smoking cessation programs and improving quit rates, especially among low-income and Medicaid populations. These incentives work by motivating individuals to participate in treatments and use medications that aid in quitting smoking. ^{1 2 3 4 5}

Is it safe to use financial incentives for quitting smoking?

The research does not specifically mention any safety concerns related to using financial incentives for quitting smoking. However, studies on smoking cessation medications, which may be used alongside financial incentives, have reported some adverse events (unwanted side effects). ^{1 4 5 6 7}

How does the treatment of financial incentives for smoking cessation differ from other treatments?

This treatment is unique because it combines financial incentives with smoking cessation pharmacotherapy, encouraging people to quit smoking by offering monetary rewards, which is different from traditional methods that rely solely on medications or counseling. ^{1 4 5 8 9}

Research Team

Joseph Ladapo, MD, PhD

Principal Investigator

University of California, Los Angeles

Scott Sherman, MD

Principal Investigator

NYU Langone Health

Eligibility Criteria

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 am 18 years old or older.

I can give my consent in English or Spanish.

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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 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]

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]

References

1. Netherlands pubmed.ncbi.nlm.nih.gov

Incentives and Patches for Medicaid Smokers: An RCT. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

A randomized controlled trial of financial incentives to low income pregnant women to engage in smoking cessation treatment: Effects on post-birth abstinence. [2019]

3. United States pubmed.ncbi.nlm.nih.gov

Medicaid Incentives for Preventing Chronic Disease: Effects of Financial Incentives for Smoking Cessation. [2019]

4. England pubmed.ncbi.nlm.nih.gov

Going Once, Going Twice: Using Willingness-to-Accept Auctions to Promote Smoking Cessation. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

A randomized controlled trial of financial incentives for smoking cessation. [2022]

6. England pubmed.ncbi.nlm.nih.gov

Frequently Reported Adverse Events With Smoking Cessation Medications: Post Hoc Analysis of a Randomized Trial. [2021]

7. England pubmed.ncbi.nlm.nih.gov

Empowering smokers with a web-assisted tobacco intervention to use prescription smoking cessation medications: a feasibility trial. [2019]

8. United States pubmed.ncbi.nlm.nih.gov

Financial Incentives for Smoking Cessation in Hospitalized Patients: A Randomized Clinical Trial. [2021]

9. England pubmed.ncbi.nlm.nih.gov

Effects of large financial incentives on motivation to quit smoking and on cigarette dependence. [2023]