Financial Incentives for Smoking Cessation

Recruiting in Palo Alto (17 mi)

Overseen by Michelle R vanDellen, PhD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: University of Georgia

Must be taking: Nicotine replacement

Disqualifiers: Psychosis, E-cigarettes, Heart disease, others

No Placebo Group

Approved in 2 Jurisdictions

Trial Summary

What is the purpose of this trial?

Smokers partnered with other smokers (i.e., dual-smoker couples) represent \~2/3 of all smokers. Dual-smoker couples (DSCs) are less likely to try to quit smoking and more likely to relapse during a quit attempt, reducing overall smoking cessation rates and representing a high-risk clinical population. Despite their high prevalence and risk for persistent smoking, however, there are limited data on smoking cessation interventions among DSCs. Building on previous research that suggests a) financial incentive treatments (FITs) are effective at increasing quit rates and b) dyadic adaptations of FITs are feasible for implementation in DSCs, the proposed study will systematically two versions of FITs to enhance smoking cessation among DSCs. In addition to determining the efficacy of these dyadic FITs for smoking abstinence in DSCs, the investigators will consider the cost and cost effectiveness of each adaptation as well as mechanisms of change to inform future implementation research. The investigators will additionally consider secondary outcomes including abstinence during treatment and long-term abstinence maintenance after end of treatment. The investigators will address these questions in a three-group randomized controlled trial (RCT). In all conditions, individuals who have smoking partners (i.e., targets) will receive usual care (combination fast and slow acting Nicotine Replacement Therapy + quitting resources). In two conditions, participants will receive incentives for abstinence at three time points (1, 3, and 6 months post-baseline). In the SFIT condition, only the target in a couple will be offered incentives; in the DFIT condition, both target and partner will be offered incentives. Primary efficacy outcome is % point-prevalence abstinence at 6 months post-baseline among targets. Secondary outcomes are point-prevalence abstinence at 1 and 3 months during the treatment and 6 months post-treatment (12-months post-baseline), as well as partner outcomes. The investigators will evaluate possible mechanisms of change including partner support and individual and partner motivation to quit as well as evaluate the cost and relative cost of each abstainer within and across condition. These data on the efficacy, mechanisms, and costs of FITs for DSCs will inform population level implementation and promote successful quitting in this treatment refractory population.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, you will receive usual care, which includes Nicotine Replacement Therapy, so it's best to discuss with the trial team if you have concerns about your current medications.

What data supports the effectiveness of the treatment Financial Incentive Treatment (FIT) for smoking cessation?

Research shows that financial incentives can be effective in helping people quit smoking, especially when combined with other support like group training. Studies have found that offering financial rewards can increase the chances of quitting, even in challenging situations like pregnancy or among low-income individuals.

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Is the Financial Incentive Treatment for smoking cessation safe for humans?

The research articles provided do not contain specific safety data regarding the use of financial incentives for smoking cessation, focusing instead on effectiveness and perceptions.

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How is the Financial Incentive Treatment (FIT) for smoking cessation different from other treatments?

The Financial Incentive Treatment (FIT) is unique because it uses financial rewards to motivate people to quit smoking, which is different from traditional methods like nicotine replacement therapies or counseling. This approach can be combined with other interventions, such as group training, to potentially increase its effectiveness.

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Eligibility Criteria

This trial is for couples where both partners smoke cigarettes. They must be willing to try quitting together and participate in a study that involves financial incentives as motivation. Specific eligibility details are not provided, but typically participants would need to meet certain health criteria and commit to the study's schedule.

Inclusion Criteria

I am 18 years old or older.

Romantic relationship duration of at least six months

Smoking of 5+ cigarettes/day

Exclusion Criteria

Marijuana use

Less than 8th grade capacity to read and write in English

Psychosis risk

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline

Participants complete a baseline session and are offered quitting resources

1 session

1 visit (remote video conference)

Treatment

Participants receive financial incentives for abstinence at 1, 3, and 6 months post-baseline

6 months

3 visits (remote video conference)

Follow-up

Participants are monitored for long-term abstinence and smoking behavior

6 months

1 visit (remote video conference)

Participant Groups

The trial tests two versions of Financial Incentive Treatments (FITs) designed to help dual-smoker couples quit smoking. Participants will receive usual care plus potential cash rewards for abstaining from smoking at set intervals. One group gets incentives just for one partner, while the other group has both partners receiving incentives.

Group I: Single-Target FIT (SFIT) Experimental Treatment 1 Intervention

One couple member offered incentives. Targets in the SFIT condition will be offered financial incentives for biochemically verified abstinence ($200 at each of three follow-ups \[1, 3, and 6 Month\]).

Group II: Dyadic-FIT condition (DFIT) Experimental Treatment 1 Intervention

Both couple members offered incentives and tracked across 12 months. Both targets and partners will be offered financial incentives for abstinence. Thus, in this condition, the total financial incentives offered to the dyad are twice the amount as offered to participants in the SFIT condition.

Group III: No-FIT Treatment-as-Usual (TAU) Condition Active Control 1 Intervention

Participants in the no-FIT control condition will not receive incentives.

Financial Incentive Treatment (FIT) is already approved in United States, European Union for the following indications:

🇺🇸 Approved in United States as Financial Incentive Treatment for:

• Smoking cessation

🇪🇺 Approved in European Union as Financial Incentive Treatment for:

• Smoking cessation

Find a Clinic Near You

Research Locations Nearby Select from list below to view details:

University of Georgia Athens, GA

Who Is Running the Clinical Trial?

University of Georgia Lead Sponsor

McMaster University Collaborator

University of Kentucky Collaborator

References

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

Incentives and Patches for Medicaid Smokers: An RCT. [2019] Most successful trials of financial incentives for smoking cessation have offered large rewards contingent on outcomes. This study examines whether more modest incentives to encourage engagement, non-contingent on outcomes, also increase cessation; whether sending medications directly to participants boosts quitting; and whether these strategies are effective in Medicaid.

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

Financial incentives for smoking cessation in pregnancy: a single-arm intervention study assessing cessation and gaming. [2022] Financial incentives were the single most effective intervention for smoking cessation in pregnancy in a recent Cochrane Review, but based on a few small trials in the United States using only 7-day point prevalence measures of cessation. This study estimates (a) prolonged cessation in an unselected population of English pregnant smokers who are offered financial incentives for quitting and (b) 'gaming', i.e. false reporting of smoking status to enter the scheme or gain an incentive.

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

Effectiveness of providing financial incentives to healthcare professionals for smoking cessation activities: systematic review. [2018] Financial incentives are seen as one approach to encourage more systematic use of smoking cessation interventions by healthcare professionals. A systematic review was conducted to examine the evidence for this.

4. 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] Financial incentives are potentially useful tools to aid smoking cessation, but robust evidence to support their efficacy, particularly in combination with other interventions (eg, group counselling), has not been reported. We aimed to investigate whether financial incentives combined with a smoking cessation group training programme (compared with a training programme with no incentives) organised at the workplace would increase 12-month abstinence rates in tobacco-smoking employees with different education and income levels.

5. 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] Smoking remains the leading preventable cause of death in the USA. Low utilisation of treatments for smoking cessation remains a major barrier for reducing smoking rates. Financial incentives represent an innovative approach to increasing use of therapies for smoking cessation. This paper will describe the rationale and design of the Financial Incentives for Smoking Treatment II (FIESTA II) study, a randomised controlled trial to evaluate the effectiveness and feasibility of goal-directed and outcome-based financial incentives to promote smoking cessation among hospitalised smokers.

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

A randomized controlled trial of financial incentives for smoking cessation. [2022] Although 435,000 Americans die each year of tobacco-related illness, only approximately 3% of smokers quit each year. Financial incentives have been shown to be effective in modifying behavior within highly structured settings, such as drug treatment programs, but this has not been shown in treating chronic disease in less structured settings. The objective of this study was to determine whether modest financial incentives increase the rate of smoking cessation program enrollment, completion, and quit rates in a outpatient clinical setting.

7. 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] Financial incentives can support smoking cessation, yet low acceptability may limit the wider implementation of such schemes. Few studies have examined how smokers view financial-incentive interventions aimed at reducing smoking prevalence.

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

Higher incentive amounts do not appear to be associated with greater quit rates in financial incentive programmes for smoking cessation. [2021] Financial incentive (FI) programmes can promote smoking cessation. While foundational research suggests higher FI amounts may better produce outcomes, confirmation is needed. Further, the optimal amount(s) needed to cost-effectively promote change is unclear. Our objective was to reconfirm whether higher amounts are associated with greater quitting through review of previous programmes, before assessing whether non-linear trends and obvious inflections in this relationship exist which may highlight optimal amounts.