Breen Rachel J, Ferguson Stuart G, Palmer Matthew A
College of Health and Medicine, University of Tasmanian, Australia.
College of Health and Medicine, University of Tasmanian, Australia.
Addict Behav. 2020 Nov;110:106513. doi: 10.1016/j.addbeh.2020.106513. Epub 2020 Jun 11.
Financial incentive (FI) programmes can promote smoking cessation. While foundational research suggests higher FI amounts may better produce outcomes, confirmation is needed. Further, the optimal amount(s) needed to cost-effectively promote change is unclear. Our objective was to reconfirm whether higher amounts are associated with greater quitting through review of previous programmes, before assessing whether non-linear trends and obvious inflections in this relationship exist which may highlight optimal amounts.
Four databases were searched for controlled or randomised controlled studies which detailed FI programmes for smoking cessation in adults.
Twenty-six studies were included. Programmes varied in length (3.0-52.0 weeks, median = 12.0), FI provision timing, and longest follow-up (5.5-24.0 months, median = 6.0). The odds ratio of quitting at longest follow-up ranged from 0.32 to 5.89. Maximum FI amounts were between US$106.19 and $4,027.92. Quit rates and amounts were not significantly correlated. Subsequent comparisons to reduce between-study variations were non-significant. Further analyses revealed no evidence of non-linear fits, changes in inflection, or cut-points.
While higher FI amounts were not associated with greater quitting within this review, the limited data available and variations in target populations and programme designs unrelated to the amount have undoubtedly influenced results. Findings suggest information on this relationship and optimal FI amounts are not determinable through current evidence. As this information is important for cost-effectiveness evaluations and real-world viability, further investigation is necessary. Laboratory research could provide valuable initial insight. Trials comparing programme efficacy under the identified amounts could then be implemented.
经济激励（FI）计划可以促进戒烟。虽然基础研究表明更高的FI金额可能更有利于产生效果，但仍需要进行确认。此外，以具有成本效益的方式促进改变所需的最佳金额尚不清楚。我们的目标是在评估这种关系中是否存在非线性趋势和明显拐点（可能突出最佳金额）之前，通过回顾以前的计划来再次确认更高的金额是否与更高的戒烟成功率相关。
检索了四个数据库，以查找详细介绍成人戒烟FI计划的对照研究或随机对照研究。
纳入了26项研究。各计划在时长（3.0 - 52.0周，中位数 = 12.0）、FI提供时间和最长随访时间（5.5 - 24.0个月，中位数 = 6.0）方面存在差异。最长随访时戒烟的优势比范围为0.32至5.89。最大FI金额在106.19美元至4027.92美元之间。戒烟率与金额之间无显著相关性。随后为减少研究间差异所做的比较无显著意义。进一步分析未发现非线性拟合、拐点变化或切点的证据。
虽然在本综述中更高的FI金额与更高的戒烟成功率无关，但现有数据有限以及目标人群和计划设计中与金额无关的差异无疑影响了结果。研究结果表明，通过当前证据无法确定这种关系以及最佳FI金额的信息。由于这些信息对于成本效益评估和实际可行性很重要，因此有必要进行进一步调查。实验室研究可以提供有价值的初步见解。然后可以开展比较在确定金额下计划疗效的试验。
