Could Cash Be the Key to Getting Smokers to Kick the Habit?

Pregnant women who were paid to give up smoking were more successful than those who just received counseling.

(Photo: Jasper White/Getty Images)

Jan 29, 2015· 1 MIN READ
Culture and education editor Liz Dwyer has written about race, parenting, and social justice for several national publications. She was previously education editor at Good.

Meditation, medication, patches, gum, counseling, and cold turkey: You probably know a smoker who has tried—and failed—to kick the habit with one of those methods. It turns out that your cancer stick–puffing friends and relatives might be a bit more successful if you (or someone) forked over some cash.

That’s what the results of a new study published in the journal BMJ suggest. After researchers in the U.K. dangled up to $1,200 in shopping vouchers in front of each of 612 low-income pregnant women, nearly 25 percent of those soon-to-be moms ditched the unhealthy habit. In comparison, only about 9 percent of pregnant women who were only offered smoking cessation counseling quit.

Instead of making the women wait months to get the reward, the researchers gradually doled out the financial incentive. The women received a voucher worth about $100 after they showed up for an initial appointment and set a quit date. Four weeks later, if an exhaled carbon monoxide breath test showed that they hadn’t lit up, the women received another $100 voucher. At the 12-week mark, the women were given a voucher worth at least $200 if they still hadn’t smoked. The balance of the financial reward was paid to the participants if the breath test showed they hadn’t smoked before their 38th week of pregnancy.

What’s particularly noteworthy is that the women all came from low-income communities around Glasgow.

“In the developed world there is now a clear socioeconomic gradient in smoking, with tobacco use concentrated among the poorest in society,” wrote the study’s authors. “Receipt of financial incentives can contribute to needed household income in advance of the arrival of a baby in low income households.”

That those women managed to quit, is, of course, good news for their babies’ health. Infants born to moms who smoke have an increased risk of birth defects and low birth weight and are more likely to die from sudden infant death syndrome. Some studies have also shown that down the road, kids whose moms puffed cigarettes tend to be more obese.

Kicking the habit permanently tends to be the hurdle most people who are trying to stop smoking struggle with. To measure the long-term efficacy of paying people, the researchers checked in with the women a year after the initial study. It turns out that 15 percent of the women who’d received the vouchers could still call themselves nonsmokers. That might not seem that impressive, but in comparison, only 4 percent of the moms who were in the counseling-only control group were still not smoking.

“If financial incentives are effective and cost effective they may well have the future potential to sit with vaccines as an important preventive healthcare intervention strategy,” wrote the researchers. So does this mean that governments in the U.K. are going to start paying people to quit? It might. But since health officials there are so concerned about young people picking up smoking that last year they suggested banning cigarette sales to anyone born after 2000, perhaps paying folks to never start lighting up could be in the cards.