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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if financial incentives can help Alaska Native and American Indian families quit smoking. Participants in the experimental group will receive rewards for remaining smoke-free, verified six times over six months. Those who have smoked at least three cigarettes daily for the past three months and wish to quit may be suitable candidates. The study also requires participants to involve a family member and have access to a mobile device. Participants will complete smoking tests and may receive an iPad to assist with the study. As an unphased trial, this study offers a unique opportunity to contribute to research that could benefit the community.

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 prior data suggests that this family-based financial incentives intervention is safe?

Research has shown that using financial rewards to help families quit smoking is generally safe. One study examined this method with Alaska Native and American Indian families and found it feasible, with no major safety issues reported.

Financial incentives involve giving rewards, such as cash or vouchers, to encourage smoking cessation. Other studies have used these rewards without causing serious problems, and this method appears well-received.

While sources do not mention specific safety concerns, financial incentives primarily affect behavior. This results in a lower risk of harmful side effects compared to treatments involving medication or medical procedures. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Financial Incentives for Smoking Cessation trial because it explores a unique approach to helping people quit smoking using family-based financial incentives. Unlike traditional methods like nicotine replacement therapy or prescription medications, this trial leverages the power of financial rewards to motivate behavioral change. The idea is that immediate, tangible rewards for not smoking might encourage participants to stay smoke-free more effectively. By involving family support and providing monetary incentives, this intervention could offer a new, potentially more engaging way to help people quit smoking for good.

What evidence suggests that the Family-Based Financial Incentives Intervention could be effective for smoking cessation?

This trial will evaluate the effectiveness of financial incentives for smoking cessation. Research has shown that offering money can help people quit smoking. One study found that individuals who received both regular support and financial rewards were more likely to quit than those who only received regular support. Another study found that programs involving family support can reduce daily smoking and encourage quitting attempts. Although paying people to quit smoking might seem unusual, evidence suggests it works, especially when families are involved. This method appears promising for Alaska Native and American Indian families trying to quit smoking. Participants in this trial will join either the Rewards Group, which includes financial incentives, or the Comparison Group, which does not. ^{1 2 3 6 7}

Who Is on the Research Team?

Christi A Patten, PhD

Principal Investigator

Mayo Clinic

Are You a Good Fit for This Trial?

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: 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

Index Participant: Own or have access to a mobile phone or tablet with Internet and text messaging capabilities, or will be loaned an iPad for the study duration

Exclusion Criteria

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

Index Participant: Participated in a prior study phase

Family Member Participant: Already enrolled with another family member

Timeline for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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]

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]

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]

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 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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11986626/

Beta-testing the feasibility of a family-based financial ... Conclusion. A family-based financial incentive intervention for smoking cessation with ANAI families appears feasible. Next, a randomized ...

2. trialx.com trialx.com/clinical-trials/listings/310212/family-based-financial-incentives-intervention-for-smoking-cessation/

Family-Based Financial Incentives Intervention for Smoking ... The current study will conduct an RCT to evaluate the effectiveness of a family-based incentive intervention with Alaska Native/American Indian families. The ...

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

Financial Incentives for Smoking Cessation Among ... This randomized clinical trial of 320 participants compared usual care (counseling and pharmacotherapy) with usual care plus modest financial incentives.

4. sciencedirect.com sciencedirect.com/science/article/pii/S2589537025003529

Effectiveness of family-based behavioral intervention for ... Parents receiving family-based behavioral interventions showed greater reductions in daily cigarette consumption, increased quit attempts, ...

5. clinicaltrials.gov clinicaltrials.gov/study/NCT01303081

Pilot Randomized Control Trial of Financial Incentives for ... This study is designed to explore the potential efficacy of using internet-based incentive programs to promote smoking cessation. We also hope to document ...

6. mayo.edu mayo.edu/research/clinical-trials/cls-20539920

Alaska Native Family-Based, Financial Incentives ... The objective of the proposed study is to evaluate the effectiveness and implementation of a culturally adapted, ANAI family-based incentives intervention for ...

7. formative.jmir.org formative.jmir.org/2023/1/e44979

A Financial Incentives Program to Promote Smoking ... Financial incentives for smoking cessation are an intervention in which participants receive incentives, such as cash payments or vouchers for ...