Although many people in recovery smoke – it’s even encouraged at some treatment centers, though this is a lot less common than it used to be – lighting up isn’t a great way to keep relapse at bay. In fact, a recent study shows that stamping out your nicotine habit may make it easier to recover from a substance use disorder as well as depression or an anxiety disorder.
Once you do decide to leave cigarettes or other tobacco products behind, the question is typically: Which method is best for quitting? So far, that’s not been easy to answer, partly because quitting smoking is very difficult for many people, often requiring multiple attempts. From patches and gums to motivational text messages and smartphone apps, smoking cessation tools abound.
What might help, though, is a particularly attractive incentive: Would you quit for cash? For instance, if you got paid for not lighting up, or perhaps access to free nicotine replacement therapy, like gum, medications or patches – would that do the trick? Or, conversely, if you were afraid of losing money – if you had to pay if you fell off the wagon – would that motivate you?
Answers to these questions were exactly what researchers set out to discover in the largest trial to date testing the influence of financial penalty in smoking cessation. The study, funded by the National Institutes of Health and CVS Caremark and published earlier this month in the New England Journal of Medicine, involved more than 2,000 participants, comprised of CVS Caremark employees as well as their friends and families.
What’s It Worth to You?
The researchers found that offering a significant financial incentive – $800 for abstaining from smoking for six months — was much more effective than traditional smoking cessation approaches, like counseling or nicotine replacement therapy (gum, patches, medication). Perhaps more interesting, however, was that the study also found that requiring a $150 deposit – which wouldn’t be refunded if the person failed to stay smoke-free for six months – nearly doubled the chances of successfully quitting. More than half of participants who paid the $150 deposit had quit smoking by the end of the six-month trial, compared to only 17% of those in the $800 reward program. About 25% of smokers who use medicines can stay smoke-free for over six months, according to the American Cancer Society.
The idea of paying people to become healthy isn’t a new one. In fact, in recent years, the idea of doling out cash rewards for, say, visiting a doctor or adhering to a medication schedule or even sticking with exercise, has become a popular subject of research. Results have been mixed, though. One major study by the HIV Prevention Trials Network, for example, failed to show the effectiveness of financial incentives to improve medication adherence among HIV patients. Yet, when it comes to weight loss, study participants who received monetary incentives lost more weight than those who received none, according to Mayo Clinic research.
Other studies have found that money talks when it comes to quitting smoking. Even small financial incentives (up to $150 in gift cards) doubled smoking cessation rates among low-income smokers, according to research from the University of Texas Health Science Center at Houston. In yet another study in BMJ, pregnant women promised up to $600 in shopping vouchers were more than twice as likely to give up cigarettes compared to those referred for routine smoking cessation services.
While these and the New England Journal of Medicine findings are promising, the fact remains that there’s no single stop-smoking approach that will work for everyone. And all the riches in the world probably won’t help if you’re not ready to commit to quitting, which includes having a good support system in place. Although 70% of smokers say they want to quit, only 4% to 7% can do it without medicines or other help, according to the American Cancer Society. When you are ready, take the first step by talking with your health care professional to find a smoking cessation approach that works for you – whether that means placing a wager with a friend to encourage each other to stop smoking, using the nicotine patch or gum or finding counseling or a support group, or a combination of all of these.
What’s worked (or hasn’t) for you when it comes to quitting smoking?