National Center for Health Marketing, CDC, Atlanta, Georgia 30333, USA.
Am J Prev Med. 2010 Feb;38(2 Suppl):S263-74. doi: 10.1016/j.amepre.2009.10.034.
The Guide to Community Preventive Service (Community Guide) methods for systematic reviews were used to evaluate the evidence of effectiveness of worksite-based incentives and competitions to reduce tobacco use among workers. These interventions offer a reward to individuals or to teams of individuals on the basis of participation or success in a specified smoking behavior change (such as abstaining from tobacco use for a period of time). The review team identified a total of 26 published studies, 14 of which met study design and quality of execution criteria for inclusion in the final assessment. Only one study, which did not qualify for review, evaluated the use of incentives when implemented alone. All of the 14 qualifying studies evaluated incentives and competitions when implemented in combination with a variety of additional interventions, such as client education, smoking cessation groups, and telephone cessation support. Of the qualifying studies, 13 evaluated differences in tobacco-use cessation among intervention participants, with a median follow-up period of 12 months. The median change in self-reported tobacco-use cessation was an increase of 4.4 percentage points (a median relative percentage improvement of 67%). The present evidence is insufficient to determine the effectiveness of incentives or competitions, when implemented alone, to reduce tobacco use. However, the qualifying studies provide strong evidence, according to Community Guide rules, that worksite-based incentives and competitions in combination with additional interventions are effective in increasing the number of workers who quit using tobacco. In addition, these multicomponent interventions have the potential to generate positive economic returns over investment when the averted costs of tobacco-associated illnesses are considered. A concurrent systematic review identified four studies with economic evidence. Two of these studies provided evidence of net cost savings to employers when program costs are adjusted for averted healthcare expenses and productivity losses, based on referenced secondary estimates.
采用社区预防服务指南（社区指南）的系统评价方法，评估了基于工作场所的激励和竞赛措施在减少工人烟草使用方面的有效性证据。这些干预措施根据个人或个人团队参与或成功实现特定吸烟行为改变（例如一段时间内不吸烟）的情况提供奖励。审查小组共确定了 26 项已发表的研究，其中 14 项符合纳入最终评估的研究设计和执行质量标准。只有一项未达到审查标准的研究评估了单独实施激励措施的效果。所有 14 项合格研究都评估了激励措施和竞赛措施与各种其他干预措施（如客户教育、戒烟小组和电话戒烟支持）结合使用时的效果。在合格研究中，有 13 项评估了干预参与者中烟草使用停止的差异，中位随访期为 12 个月。自我报告的烟草使用停止率中位数变化为增加 4.4 个百分点（中位数相对百分比提高 67%）。目前的证据不足以确定单独实施激励措施或竞赛措施以减少烟草使用的有效性。然而，根据社区指南的规则，合格研究提供了强有力的证据，表明基于工作场所的激励措施和竞赛措施与其他干预措施相结合，可以有效增加戒烟的工人人数。此外，当考虑到与烟草相关的疾病的避免成本时，这些多组分干预措施具有产生积极的投资回报的潜力。同时进行的系统评价确定了四项具有经济证据的研究。其中两项研究根据参考二次估计，为雇主提供了在调整计划成本以避免医疗保健费用和生产力损失后节省净成本的证据。
