A Randomized, Controlled Trial of Financial Incentives for Smoking Cessation
A Randomized, Controlled Trial of Financial Incentives for Smoking Cessation
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DOI：
10.1056/nejmsa0806819
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发表时间：
2009-02-12
影响因子：
158.5
通讯作者：
Audrain-McGovern, Janet
中科院分区：
文献类型：
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作者：
Volpp, Kevin G.;Troxel, Andrea B.;Audrain-McGovern, Janet
研究背景在美国，吸烟是导致过早死亡的首要可预防原因。以往关于工作场所的经济刺激戒烟措施的研究并未表明此类激励措施对戒烟率有显著影响，但这些研究的效果有限，所使用的激励措施可能是不够的。方法我们随机分配了一家总部位于美国的跨国公司的878名员工，让他们接受戒烟计划的信息(442名员工)或接受有关计划和经济激励措施的信息(436名员工)。经济奖励包括完成戒烟计划100美元，经生化测试确认在研究登记后6个月内戒烟250美元，以及经生化测试确认在首次戒烟后再戒烟6个月的400美元。个体参与者根据工作地点、重度吸烟或非重度吸烟以及收入进行分层。主要终点是登记后9个月或12个月的戒烟，这取决于最初的戒烟报告是在3个月还是6个月。次要终点是登记后前6个月内的戒烟率以及参与和完成戒烟计划的比率。结果激励组在登记后9个月或12个月、15个月或18个月的吸烟率(14.7%比5.0%，P<；0.001)和15个月或18个月(9.4%比3.6%，P<；0.001)显著高于单纯信息组(P<；0.001)。激励组参与者参加戒烟计划的比率(15.4%比5.4%，P<；0.001)、戒烟计划完成率(10.8%比2.5%，P<；0.001)以及登记后前6个月内戒烟的比例(20.9%比11.8%，P<；0.001)都显著高于其他参与者。(临床试验。政府编号，NCT00128375。)。
Background Smoking is the leading preventable cause of premature death in the United States. Previous studies of financial incentives for smoking cessation in work settings have not shown that such incentives have significant effects on cessation rates, but these studies have had limited power, and the incentives used may have been insufficient.Methods We randomly assigned 878 employees of a multinational company based in the United States to receive information about smoking- cessation programs ( 442 employees) or to receive information about programs plus financial incentives ( 436 employees). The financial incentives were $ 100 for completion of a smoking- cessation program, $ 250 for cessation of smoking within 6 months after study enrollment, as confirmed by a biochemical test, and $ 400 for abstinence for an additional 6 months after the initial cessation, as confirmed by a biochemical test. Individual participants were stratified according to work site, heavy or nonheavy smoking, and income. The primary end point was smoking cessation 9 or 12 months after enrollment, depending on whether initial cessation was reported at 3 or 6 months. Secondary end points were smoking cessation within the first 6 months after enrollment and rates of participation in and completion of smoking- cessation programs.Results The incentive group had significantly higher rates of smoking cessation than did the information- only group 9 or 12 months after enrollment (14.7% vs. 5.0%, P< 0.001) and 15 or 18 months after enrollment (9.4% vs. 3.6%, P< 0.001). Incentive- group participants also had significantly higher rates of enrollment in a smoking- cessation program (15.4% vs. 5.4%, P< 0.001), completion of a smoking- cessation program (10.8% vs. 2.5%, P< 0.001), and smoking cessation within the first 6 months after enrollment (20.9% vs. 11.8%, P< 0.001).Conclusions In this study of employees of one large company, financial incentives for smoking cessation significantly increased the rates of smoking cessation. (ClinicalTrials. gov number, NCT00128375.).