Smoking Cessation Contracts with Social and Monetary Incentives

描述（由申请人提供）：戒烟服务在许多低资源环境中并不普遍，因为训练有素的咨询师稀缺，药理学方法的价格超出了许多吸烟者的承受能力。这一问题在低收入和中等收入国家尤为严重，大多数可归因于烟草的死亡发生在这些国家。这项拟议的研究测试了一套新颖的，低成本的行为方法，在泰国的大型工作场所戒烟。主要的方法，来自行为经济学，是一个承诺合同，一个协议，个人约束自己实现一个目标，以保持自我控制。具体来说，参与吸烟者存入的钱只有在成功戒烟后才能返还。这项研究交叉随机化了戒烟承诺合同，其中有两个因素可以促进行为改变：经济和社会激励。 我们建议在100家公司的3,200名吸烟者样本中进行一项随机对照试验，进行3个月的干预和3、6和12个月的随访。该研究将跟踪来自同一公司的另外4，800名吸烟者，他们选择不参与干预。拟议的干预措施随机分配参与者到四种类型的承诺合同中的一种，包括没有合同，以及三个级别的现金奖励中的一个，包括没有奖金。这些合同的结构是这样的：一些参与者因辞职而获得现金奖励;其他人被随机分配到一个两人团队，只有当两个成员都辞职时才能获得现金奖励;其他人可以在两种激励计划之间做出选择。析因设计将允许识别几种因果机制对戒烟的影响：财务承诺，同伴压力，社会支持和金钱奖励。这项研究将提供一些第一批证据，证明用现金奖励和社会承诺补充基本承诺合同的价值。该研究进一步比较了每种类型的承诺合同与标准临床戒烟方法的成本。在这样做的过程中，这项研究将告知政策制定者一套新颖，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.