Volpp Kevin G, Gurmankin Levy Andrea, Asch David A, Berlin Jesse A, Murphy John J, Gomez Angela, Sox Harold, Zhu Jingsan, Lerman Caryn
CHERP, Philadelphia Veterans Affairs Medical Center, University and Woodland Ave., Philadelphia, PA 19104-6021, USA.
Cancer Epidemiol Biomarkers Prev. 2006 Jan;15(1):12-8. doi: 10.1158/1055-9965.EPI-05-0314.
Although 435,000 Americans die each year of tobacco-related illness, only approximately 3% of smokers quit each year. Financial incentives have been shown to be effective in modifying behavior within highly structured settings, such as drug treatment programs, but this has not been shown in treating chronic disease in less structured settings. The objective of this study was to determine whether modest financial incentives increase the rate of smoking cessation program enrollment, completion, and quit rates in a outpatient clinical setting.
179 smokers at the Philadelphia Veterans Affairs Medical Center who reported smoking at least 10 cigarettes per day were randomized into incentive and non-incentive groups. Both groups were offered a free five-class smoking cessation program at the Philadelphia Veterans Affairs Medical Center. The incentive group was also offered $20 for each class attended and $100 if they quit smoking 30 days post program completion. Self-reported smoking cessation was confirmed with urine cotinine tests.
The incentive group had higher rates of program enrollment (43.3% versus 20.2%; P<0.001) and completion (25.8% versus 12.2%; P=0.02). Quit rates at 75 days were 16.3% in the incentive group versus 4.6% in the control group (P=0.01). At 6 months, quit rates in the incentive group were not significantly higher (6.5%) than in the control group (4.6%; P>0.20).
Modest financial incentives are associated with significantly higher rates of smoking cessation program enrollment and completion and short-term quit rates. Future studies should consider including an incentive for longer-term cessation.
尽管每年有43.5万美国人死于与烟草相关的疾病，但每年只有约3%的吸烟者戒烟。在高度结构化的环境中，如戒毒治疗项目，经济激励已被证明能有效改变行为，但在结构化程度较低的环境中治疗慢性病时，尚未有此类效果的证明。本研究的目的是确定适度的经济激励是否能提高门诊临床环境中戒烟项目的参与率、完成率和戒烟率。
费城退伍军人事务医疗中心的179名每天至少吸10支烟的吸烟者被随机分为激励组和非激励组。两组均在费城退伍军人事务医疗中心获得免费的五节戒烟课程。激励组每参加一节课可获得20美元，若在课程结束后30天戒烟还可获得100美元。通过尿液可替宁检测来确认自我报告的戒烟情况。
激励组的项目参与率更高（43.3%对20.2%；P<0.001），完成率也更高（25.8%对12.2%；P=0.02）。激励组75天时的戒烟率为16.3%，而对照组为4.6%（P=0.01）。6个月时，激励组的戒烟率（6.5%）与对照组（4.6%）相比没有显著更高（P>0.20）。
适度的经济激励与显著更高的戒烟项目参与率、完成率和短期戒烟率相关。未来的研究应考虑加入长期戒烟的激励措施。
