Department of Family Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands.
Department of Family Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands; Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands; IVO Addiction Research Institute, The Hague, Netherlands.
Lancet Public Health. 2018 Nov;3(11):e536-e544. doi: 10.1016/S2468-2667(18)30185-3. Epub 2018 Oct 18.
Financial incentives are potentially useful tools to aid smoking cessation, but robust evidence to support their efficacy, particularly in combination with other interventions (eg, group counselling), has not been reported. We aimed to investigate whether financial incentives combined with a smoking cessation group training programme (compared with a training programme with no incentives) organised at the workplace would increase 12-month abstinence rates in tobacco-smoking employees with different education and income levels.
This cluster-randomised controlled trial was done in the Netherlands with companies that offer a smoking cessation group training programme to all of their smoking employees. Eligible participants were tobacco-smoking employees and spouses of employees who were at least 18 years of age. Participants in the control group received a weekly 90-min session of smoking cessation group training for 7 weeks at the workplace; in addition to the group training, participants in the intervention group received vouchers for being abstinent (€50 at the end of the training programme, €50 3 months after completion of the programme, €50 after 6 months, and €200 after 12 months). Companies were randomly assigned by an independent research assistant to the intervention group or the control group with a digital randomisation programme, using a biased urn method. The primary outcome was carbon monoxide-validated continuous abstinence at 12 months. All randomised participants were included in the modified intention-to-treat analyses, with the exception of unavoidable loss (participants who had died or moved to an untraceable address (according to the Russell Standard), and in the sensitivity analyses, except the complete case analysis, which included only participants for whom all variables included in the model were not missing. This study is registered with the Dutch Trial Register, number NTR5657.
Between March 1, 2016, and March 1, 2017, 61 companies with 604 participating smokers were enrolled. 31 companies (319 smokers) were randomly assigned to the intervention group and 30 companies (285 smokers) to the control group. 12 months after finishing the smoking cessation programme, the proportion of individuals abstaining from smoking in the intervention group was significantly higher than that in the control group (131 [41%] of 319 vs 75 [26%] of 284; adjusted odds ratio 1·93, 95% CI 1·31-2·85, p=0·0009; adjusted for education level, income level, and Fagerström score).
Financial incentives in addition to a smoking cessation group training programme can significantly increase long-term smoking abstinence. The results of the current study could motivate employers to facilitate a workplace smoking cessation programme with financial incentives to help employees to quit smoking.
Dutch Cancer Society.
经济激励措施可能是帮助戒烟的有效工具，但尚未有强有力的证据支持其疗效，尤其是在与其他干预措施（如团体咨询）结合使用时。我们旨在研究在工作场所组织的经济激励措施与戒烟团体培训计划（与没有激励措施的培训计划相比）相结合是否会提高不同教育和收入水平的吸烟员工的 12 个月戒烟率。
这是一项在荷兰进行的群组随机对照试验，涉及为所有吸烟员工提供戒烟团体培训计划的公司。合格参与者为年龄至少 18 岁的吸烟员工和员工的配偶。对照组的参与者在工作场所接受每周 90 分钟的戒烟团体培训 7 周；除了团体培训外，干预组的参与者在戒烟时获得代金券（培训计划结束时 50 欧元，计划完成后 3 个月 50 欧元，6 个月后 50 欧元，12 个月后 200 欧元）。采用偏倚 urn 方法，由独立研究助理使用数字随机化程序将公司随机分配到干预组或对照组。主要结局为 12 个月时经一氧化碳验证的持续戒烟。除不可避免的损失外（已死亡或搬到无法追踪地址的参与者（根据 Russell 标准），以及在敏感性分析中，除完全案例分析外，所有随机参与者均包括在修改后的意向治疗分析中，完全案例分析仅包括所有纳入模型的变量均未缺失的参与者。这项研究在荷兰试验登记处注册，编号为 NTR5657。
2016 年 3 月 1 日至 2017 年 3 月 1 日，共有 61 家公司的 604 名参与吸烟者被纳入研究。31 家公司（319 名吸烟者）被随机分配到干预组，30 家公司（285 名吸烟者）被随机分配到对照组。戒烟计划完成 12 个月后，干预组中戒烟的个体比例明显高于对照组（319 人中 131 人[41%]与 284 人中 75 人[26%]；调整后的优势比 1.93，95%CI 1.31-2.85，p=0.0009；调整了教育水平、收入水平和 Fagerström 评分）。
除了戒烟团体培训计划外，经济激励措施还可以显著提高长期戒烟率。目前的研究结果可能会促使雇主为员工提供有经济激励的工作场所戒烟计划，以帮助他们戒烟。
荷兰癌症协会。
