Smoking Cessation Contracts with Social and Monetary Incentives

描述（由申请人提供）：在许多资源匮乏的环境中，戒烟服务并没有广泛提供，因为训练有素的咨询师稀缺，而且药物治疗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其严重，因为大多数烟草导致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，用于在泰国的大型工作场所戒烟。来自行为经济学的主要方法是承诺契约，即个体约束自己实现目标以保持自我控制的协议。具体来说，参与计划的吸烟者要存下钱，只有在成功戒烟的情况下才会返还。该研究将戒烟承诺合同与促进行为改变的两个因素交叉随机化：经济和社会激励。我们建议进行一项随机对照试验，在100家公司的3200名吸烟者中进行为期3个月的干预和3个月、6个月和12个月的随访。该研究还将追踪来自同一家公司的另外4800名选择不参与干预的吸烟者。提议的干预将参与者随机分配到四种承诺合同类型中的一种，包括没有合同，以及三种退出现金奖励级别中的一种，包括没有奖金。合同的结构是，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小组，只有当两名成员都退出时才会获得现金奖励；而其他人则可以在这两种激励方案之间做出选择。析因设计将允许确定几个戒烟因果机制的影响：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第一手的证据，证明用现金奖励和社会承诺来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的每个戒烟者的成本与戒烟的标准临床方法。在这样做的过程中，这项研究将为政策制定者提供一系列新颖、廉价的方式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.