Caitlin Notley|Sarah Gentry|Jonathan Livingstone?Banks|Linda Bauld|Rafael Perera|Jamie Hartmann?Boyce
Incentives for smoking cessation
University of East Anglia|University of East Anglia|University of Oxford|University of Edinburgh|University of Oxford|University of Oxford
financial incentives monetary vouchers widely used attempt precipitate reinforce sustain behaviour change including smoking cessation used workplaces clinics hospitals within community programmesto determine longterm effect incentives contingency management programmes smoking cessationfor update searched cochrane tobacco addiction group specialised register clinicaltrialsgov international clinical trials registry platform ictrp recent searches conducted july 2018we considered randomised controlled trials allocating individuals workplaces groups within workplaces communities smoking cessation incentive schemes control conditions included studies mixedpopulation setting eg community work clinic institutionbased also studies pregnant smokerswe used standard cochrane methods primary outcome measure mixedpopulation studies abstinence smoking longest followup least six months start intervention trials pregnant women used abstinence measured longest followup least end pregnancy available pooled outcome data using mantelhaenzel randomeffects model results reported risk ratios rrs 95 confidence intervals cis using adjusted estimates clusterrandomised trials analysed studies carried mixed populations separately carried pregnant populationsthirtythree mixedpopulation studies met inclusion criteria covering 21600 participants 16 new version review studies set varying locations including community settings clinics health centres workplaces outpatient drug clinics judged eight studies low risk bias 10 high risk bias rest unclear risk twentyfour trials run usa two thailand one phillipines rest european incentives offered included cash payments vouchers goods groceries offered directly collected redeemable online pooled rr quitting incentives longest followup six months compared controls 149 95 ci 128 173 31 rcts adjusted n 20097 i2 33 results sensitive exclusion six studies incentive cessation offered longterm follow result excluding studies rr 140 95 ci 116 169 25 rcts adjusted n 17058 i2 36 suggesting impact incentives continues least time incentives ceasealthough always clearly reported total financial amount incentives varied considerably trials zero selfdeposits range usd 45 usd 1185 clear direction effect trials offering low high total value incentives encouraging redeemable selfdepositswe included 10 studies 2571 pregnant women judged two studies low risk bias one high risk bias seven unclear risk pooled nine trials usable data eight conducted usa one uk delivered rr longest followup 24 weeks postpartum 238 95 ci 154 369 n 2273 i2 41 favour incentivesoverall highcertainty evidence incentives improve smoking cessation rates longterm followup mixed population studies effectiveness incentives appears sustained even last followup occurs withdrawal incentives also moderatecertainty evidence limited concerns risks bias incentive schemes conducted among pregnant smokers improve smoking cessation rates end pregnancy postpartum current future research might explore precisely differences trials offering low high cash incentives selfincentives deposits within variety smoking populations