Financial Incentives for Smoking Cessation

(Aniqsaaq-RCT Trial)

Overseen By Audrey G McGuinness, BA

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Mayo Clinic

Must not be taking: Pharmacotherapy

Disqualifiers: Marijuana, Prior study, others

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

Compensation: Varies

Number of Visits: 6

Duration: 6 months

1312 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it does exclude those who have used stop smoking medications in the past 3 months.

What data supports the effectiveness of the treatment Family-Based Financial Incentives Intervention for smoking cessation?

Research shows that financial incentives, such as monetary rewards or vouchers, can help people quit smoking by encouraging and sustaining behavior change. These incentives have been used successfully in various settings, including workplaces and hospitals, to increase smoking cessation rates. ^{1 2 3 4 5}

Is the use of financial incentives for smoking cessation safe for humans?

The research articles reviewed do not provide specific safety data regarding the use of financial incentives for smoking cessation, but they focus on the effectiveness and feasibility of these interventions. ^{2 6 7 8 9}

How is the Family-Based Financial Incentives Intervention for smoking cessation different from other treatments?

This treatment is unique because it uses financial rewards to encourage people to quit smoking, which is different from traditional methods like nicotine replacement or counseling. It involves family members, making it a more supportive and community-focused approach. ^{2 3 4 6 9}

What is the purpose of this trial?

The current study will conduct an RCT to evaluate the effectiveness of a family-based incentive intervention with Alaska Native/American Indian families. The experimental arm will be compared to a control arm on biochemically-confirmed smoking abstinence at 6- and 12-months post-intervention.

Research Team

Christi A Patten, PhD

Principal Investigator

Mayo Clinic

Eligibility Criteria

This trial is for Alaska Native/American Indian families looking to quit smoking. Participants must meet certain criteria, but specific inclusion and exclusion details are not provided.

Inclusion Criteria

Index Participant: Willing to complete and sign an Internal Revenue Service (IRS) W-9 tax identification form if they wish to receive payments on the study

Index Participant: Self-report smoking in the past 7 days, biochemically verified with saliva cotinine ≥ 30 ng/mL

Index Participant: Have or will nominate one adult family member to enroll with them

Exclusion Criteria

I have used medication or a program to quit smoking in the last 3 months.

Index Participant: Already enrolled in the study with another family member

Index Participant: Participated in a prior study phase

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive a family-based incentive intervention for smoking cessation, with smoking status check-ins weekly for four weeks, then at three and six months

6 months

6 visits (in-person or virtual)

Follow-up

Participants are monitored for smoking abstinence at 12 months post-intervention

6 months

Treatment Details

Interventions

• Family-Based Financial Incentives Intervention

Trial Overview The study tests if offering financial rewards helps families stop smoking. It's a randomized controlled trial comparing this approach with a control group, checking results at 6 and 12 months after the intervention.

Participant Groups

Group I: Rewards Group Experimental Treatment 1 Intervention

Index participants in the Rewards Group will be scheduled to complete smoking status check-ins six times during the 6-month Treatment Phase: weekly for four weeks, then at three and six months. At each check-in, cigarette smoking abstinence will be assessed. Participants in the Rewards Group will receive informational materials on smoking cessation.

Group II: Comparison Group Active Control 1 Intervention

Index participants in the Comparison Group will be scheduled to complete smoking status check-ins six times during the 6-month Treatment Phase: weekly for four weeks, then at three and six months. At each check-in, cigarette smoking abstinence will be assessed. Participants in the Comparison Group will receive informational materials on smoking cessation.

Who Is Running the Clinical Trial?

Mayo Clinic

Lead Sponsor

Trials

3,427

Recruited

3,221,000+

National Institute on Drug Abuse (NIDA)

Collaborator

Trials

2,658

Recruited

3,409,000+

Alaska Native Tribal Health Consortium

Collaborator

Trials

20

Recruited

9,600+

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]

The FIESTA II study is a randomized controlled trial designed to evaluate the effectiveness of financial incentives in promoting smoking cessation among hospitalized smokers, with participants recruited from underserved communities in New York City and Los Angeles.

Participants will be divided into three groups: one receiving goal-directed financial incentives, another receiving outcome-based incentives, and a control group receiving standard care, with the potential to earn significant rewards for completing follow-up interviews and achieving smoking cessation milestones.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Goal-directed versus outcome-based financial incentives for smoking cessation among low-income, hospitalised patients: rationale and design of the Financial Incentives for Smoking Treatment II (FIESTA II) randomised controlled trial. Wali, S., Gaitonde, A., Sherman, S., et al.[2023]

Financial incentives for healthcare professionals can enhance the recording of patients' smoking status and increase the provision of smoking cessation advice, as shown in a systematic review of 18 studies.

However, the evidence is mixed regarding whether these financial incentives actually lead to significant reductions in smoking rates or improved long-term abstinence, indicating that more research is needed in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of providing financial incentives to healthcare professionals for smoking cessation activities: systematic review. Hamilton, FL., Greaves, F., Majeed, A., et al.[2018]

Financial incentives, such as cash payments or vouchers, significantly improve long-term smoking cessation rates, with a risk ratio of 1.49 in mixed populations, indicating nearly a 50% higher chance of quitting compared to controls.

Incentive schemes for pregnant smokers also show promising results, with a risk ratio of 2.38, suggesting that these programs can effectively support smoking cessation during and after pregnancy, despite some concerns about bias in the studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Incentives for smoking cessation. Notley, C., Gentry, S., Livingstone-Banks, J., et al.[2023]

A study involving 604 smokers from 61 companies in the Netherlands found that financial incentives combined with a smoking cessation group training program significantly increased the 12-month abstinence rates, with 41% of participants in the incentive group remaining smoke-free compared to 26% in the control group.

The adjusted odds ratio of 1.93 indicates that participants receiving financial incentives were nearly twice as likely to quit smoking successfully, suggesting that such incentives could be an effective strategy for workplace smoking cessation programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of a workplace-based group training programme combined with financial incentives on smoking cessation: a cluster-randomised controlled trial. van den Brand, FA., Nagelhout, GE., Winkens, B., et al.[2019]

Only 38.4% of smokers supported financial incentives for smoking cessation, with support being higher among heavy smokers and those who recently attempted to quit, indicating a need for better education on the effectiveness of such schemes.

Concerns about personal responsibility, potential abuse of the system, and fairness were major reasons for opposition to financial incentives, suggesting that addressing these issues through media advocacy could increase acceptance and implementation of these programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Perceptions of Financial Incentives for Smoking Cessation: A Survey of Smokers in a Country With an Endgame Goal. Robertson, L., Gendall, P., Hoek, J., et al.[2019]

In a study involving 239 pregnant smokers in England, financial incentives for quitting smoking led to a 20% cessation rate at delivery and a 10% cessation rate at 6 months postpartum, indicating prolonged effectiveness similar to previous US trials.

The study found minimal evidence of 'gaming' or false reporting among participants, with only 4% of enrolled women attempting to misreport their smoking status to gain incentives, suggesting that financial incentive schemes can be implemented with integrity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Financial incentives for smoking cessation in pregnancy: a single-arm intervention study assessing cessation and gaming. Ierfino, D., Mantzari, E., Hirst, J., et al.[2022]

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]

Financial incentives have been shown to be effective in promoting smoking cessation across various populations, including adolescents and individuals with mental illness, highlighting their broad applicability.

Key factors for the success of incentive programs include verifying smoking status through biochemical means, determining the appropriate size of the incentives, and establishing a suitable schedule for delivering these incentives.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The use of financial incentives in promoting smoking cessation. Sigmon, SC., Patrick, ME.[2022]

References

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

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

2. England pubmed.ncbi.nlm.nih.gov

Goal-directed versus outcome-based financial incentives for smoking cessation among low-income, hospitalised patients: rationale and design of the Financial Incentives for Smoking Treatment II (FIESTA II) randomised controlled trial. [2023]

3. England pubmed.ncbi.nlm.nih.gov

Effectiveness of providing financial incentives to healthcare professionals for smoking cessation activities: systematic review. [2018]

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

Incentives for smoking cessation. [2023]

5. England pubmed.ncbi.nlm.nih.gov

Effect of a workplace-based group training programme combined with financial incentives on smoking cessation: a cluster-randomised controlled trial. [2019]

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

Perceptions of Financial Incentives for Smoking Cessation: A Survey of Smokers in a Country With an Endgame Goal. [2019]

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

Financial incentives for smoking cessation in pregnancy: a single-arm intervention study assessing cessation and gaming. [2022]

8. England pubmed.ncbi.nlm.nih.gov

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

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

The use of financial incentives in promoting smoking cessation. [2022]