Smoking remains the leading preventable cause of premature death in the United States, accounting for approximately 438,000 deaths each year.1 Seventy percent of smokers report that they want to quit,2 but annually only 2 to 3% of smokers succeed. 3,4 Although smoking-cessation programs and pharmacologic therapies have been associated with higher rates of cessation, rates of participation in such programs and use of such therapies are low.5,6
Work sites offer a promising venue for encouraging smoking cessation because employers are likely to bear many of the excess health care costs and productivity losses that are due to missed work among smokers. In addition, existing channels of communication can be used to reach smokers and reinforce healthful behavior choices. Previous studies have shown that providing smokers with financial incentives to stop smoking increases enrollment in smoking-cessation programs and short-term cessation rates,7-10 but the studies have not shown significant increases in long-term cessation rates. Similarly, studies of financial-incentive programs in work settings have not shown significant differences in long-term cessation rates,11 though the studies generally were limited by small sample sizes and weak financial incentives.
In this randomized, controlled trial involving employees at a large, multinational company based in the United States, we tested the effectiveness of a financial incentive of up to $750 in improving long-term rates of smoking cessation.