一项关于戒烟经济激励措施的随机对照试验。

A randomized, controlled trial of financial incentives for smoking cessation.

作者信息

Volpp Kevin G, Troxel Andrea B, Pauly Mark V, Glick Henry A, Puig Andrea, Asch David A, Galvin Robert, Zhu Jingsan, Wan Fei, DeGuzman Jill, Corbett Elizabeth, Weiner Janet, Audrain-McGovern Janet

机构信息

Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, USA.

出版信息

N Engl J Med. 2009 Feb 12;360(7):699-709. doi: 10.1056/NEJMsa0806819.

DOI:10.1056/NEJMsa0806819

PMID:19213683

Abstract

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.)

摘要

背景

在美国，吸烟是可预防的过早死亡的主要原因。先前关于工作场所戒烟经济激励措施的研究并未表明此类激励措施对戒烟率有显著影响，但这些研究的效力有限，且所使用的激励措施可能并不充分。

方法

我们将一家总部位于美国的跨国公司的878名员工随机分为两组，一组接受戒烟项目信息（442名员工），另一组接受戒烟项目信息加经济激励（436名员工）。经济激励措施为：完成戒烟项目奖励100美元；经生化检测确认，在研究入组后6个月内戒烟奖励250美元；经生化检测确认，在最初戒烟后再持续6个月不吸烟奖励400美元。个体参与者根据工作地点、重度或非重度吸烟以及收入进行分层。主要终点是入组9或12个月后的戒烟情况，具体取决于最初戒烟报告是在3个月还是6个月时。次要终点是入组后前6个月内的戒烟情况以及戒烟项目的参与率和完成率。

结果

在入组9或12个月后（14.7%对5.0%，P<0.001）以及入组15或18个月后（9.4%对3.6%，P<0.001），激励组的戒烟率显著高于仅接受信息组。激励组参与者在戒烟项目的入组率（15.4%对5.4%，P<0.001）、完成率（10.8%对2.5%，P<0.001）以及入组后前6个月内的戒烟率（20.9%对11.8%，P<0.001）也显著更高。