Smoking Cessation Contracts with Social and Monetary Incentives

描述(由申请人提供)：戒烟服务在许多资源匮乏的环境中并不广泛，因为训练有素的顾问很少，而且药理方法的价格超出了许多吸烟者的承受能力。这个问题在低收入和中等收入国家尤其严重，那里发生了大多数烟草可归因于死亡的情况。这项拟议的研究测试了一套新颖、低成本的行为方法，用于在泰国的大型工作场所戒烟。源于行为经济学的主要方法是承诺契约，即个体为了保持自我控制而约束自己实现目标的协议。具体地说，参与的吸烟者存入的钱只有在成功戒烟的情况下才会返还。这项研究交叉随机地将戒烟承诺合同与两个促进行为改变的因素进行了比较：经济和社会激励。我们建议对100家公司的3200名吸烟者样本进行为期3个月的干预和3个月、6个月和12个月的随访的随机对照试验并进行评估。这项研究将跟踪来自同一家公司的另外4800名选择不参与干预的吸烟者。拟议的干预措施将参与者随机分配到四种承诺合同中的一种，包括没有合同，以及退出时获得三种水平的现金奖金中的一种，包括没有奖金。合同的结构是这样的：一些参与者在退出时获得现金奖金；另一些参与者被随机分配到一个两人团队，只有在两人都退出的情况下才能获得现金奖金；其他参与者可以在两个激励计划中进行选择。析因设计将允许确定几种因果机制对戒烟的影响：经济承诺、同伴压力、社会支持和金钱奖励。这项研究将提供一些初步证据，证明用现金奖励和社会承诺补充基本承诺合同的价值。这项研究进一步将每种承诺合同的戒烟者人均成本与标准临床戒烟方法进行了比较。通过这样做，这项研究将向政策制定者提供一套新的、廉价的方法来促进良好的健康行为。

DESCRIPTION (provided by applicant): Smoking cessation services are not widely available in many low-resource settings, because trained counselors are scarce, and pharmacological approaches are priced beyond the reach of many smokers. The problem is especially acute in low- and middle-income countries, where most tobacco-attributable deaths occur. The proposed study tests a set of novel, low-cost behavioral approaches for smoking cessation in large workplaces in Thailand. The main approach, drawn from behavioral economics, is a commitment contract, an agreement whereby individuals bind themselves to achieve a goal in order to maintain self-control. Specifically, a participating smoker deposits money that is returned only if the person quits successfully. The study cross-randomizes commitment contracts for smoking cessation with two elements to promote behavior change: financial and social incentives. We propose to conduct and evaluate a randomized controlled trial with a 3-month intervention and follow- ups at 3, 6, and 12 months in a sample of 3,200 smokers across 100 firms. The study will track an additional 4,800 smokers from the same firms who choose not to participate in the intervention. The proposed intervention randomly assigns participants to one of four types of commitment contract, including no contract, and to one of three levels of cash bonus for quitting, including no bonus. The contracts are structured such that some participants receive a cash bonus for quitting; others are randomly assigned to a two-person team and receive a cash bonus only if both members quit; and others have a choice between the two incentive schemes. The factorial design will permit the identification of the effect of several causal mechanisms on quitting: financial commitment, peer pressure, social support, and monetary rewards. The study will provide some of the first evidence on the value of supplementing a basic commitment contract with cash rewards and social commitment. The study further compares the cost per quitter of each type of commitment contract to standard clinical approaches for smoking cessation. In so doing, the study will inform policymakers about a set of novel, inexpensive ways to promote good health behaviors.