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Evidence summaries

Competitions and Incentives for Smoking Cessation

Incentives are effective for smoking cessation in the medium to long term compared with no incentives. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 48 studies involving almost 22 000 subjects. Incentives offered included cash payments or vouchers for goods and groceries, offered directly or collected and redeemable online. The risk ratio (RR) for quitting with incentives at longest follow-up (6 months or more) compared with controls was 1.52 (95% CI 1.33 to 1.74; I²=23%; 39 studies, n=18 303). The total financial amount of incentives varied considerably between trials, from zero (self-deposits), to a range of between USD 45 and USD 1185. There was no clear direction of effect between trials offering low or high total value of incentives, nor those encouraging redeemable self-deposits. 13 trials with usable data in pregnant smokers delivered an RR at longest follow-up (up to 48 weeks post-partum) of 2.13 (95% CI 1.58 to 2.86; I²=31%; 13 studies, n=3942, high-certainty evidence) in favour of incentives.

Another Cochrane review [Abstract] 2 included 81 studies. Provision of cost-free medications (RR 1.36, 95% CI 1.05 to 1.76; I² = 63%; 10 studies, n=7560) increased smoking abstinence at 6 months rates in primary care.

Comment: The quality of evidence is downgraded by limitations in study quality.

    References

    • Notley C, Gentry S, Livingstone-Banks J, et al. Incentives for smoking cessation. Cochrane Database Syst Rev 2025;1(1):CD004307. [PubMed]
    • Lindson N, Pritchard G, Hong B et al. Strategies to improve smoking cessation rates in primary care. Cochrane Database Syst Rev 2021;9():CD011556. [PubMed]

Primary/Secondary Keywords