Smoking cessation · Incentives and free products
A Pragmatic Trial of E-Cigarettes, Incentives, and Drugs for Smoking Cessation
| Design | Pragmatic randomised controlled trial |
|---|---|
| Treatment | Free cessation aids, free e-cigarettes, or free cessation aids plus financial incentives |
| Control | Usual care: information and motivational text messages |
| Population | 6006 smokers employed by a large company |
| Follow-up | 6 months |
| Primary endpoint | Sustained smoking abstinence through 6 months |
| Result | Sustained abstinence was 0.1% with usual care, 0.5% with free cessation aids, 1.0% with free e-cigarettes and higher again when financial incentives were added to free cessation aids. Among participants who actively engaged with the trial, rates were four to six times higher with similar relative effectiveness. |
| Secondary endpoints | Abstinence in the engaged cohort, uptake of cessation aids |
In this pragmatic trial of smoking cessation, financial incentives added to free cessation aids resulted in a higher rate of sustained smoking abstinence than free cessation aids alone. Among smokers who received usual care, the addition of free cessation aids or e-cigarettes did not provide a benefit.
The trial authors, in the published abstract
Look at the absolute numbers: 0.1% to 1.0% abstinence. Offering unmotivated smokers free products barely moves anything — the effect lives in engagement, and money buys engagement. The contrast with TEC, where every participant had actively sought help and abstinence reached 18%, is the whole lesson.
Halpern SD, Harhay MO, Saulsgiver K, et al. A Pragmatic Trial of E-Cigarettes, Incentives, and Drugs for Smoking Cessation. N Engl J Med 2018 Jun 14;378(24):2302-2310.