Study reveals paying people to quit smoking would be cost effective

Financial incentives would see people who managed to quit smoking for 12 month rewarded with €400.

Offering financial incentives to stop people smoking would be a cost-effective method of getting people in Ireland to give up tobacco products, according to the results of a new study.

The research estimated that financial incentives to stop smoking (Fiss) programmes could get 10,000 individuals to give up smoking for as little as €2m, with each person who managed to quit smoking for 12 months to be rewarded with €400.

It noted there are approximately 800,000 smokers in Ireland, of whom 50% have indicated they had made an attempt to quit smoking within the last 12 months.

The study by researchers at the Royal College of Surgeons in Ireland (RCSI) and the HSE’s Tobacco Free Ireland Programme found a financial incentive programme is likely to be particularly more cost-effective for smokers who are female, in younger age groups, and individuals with medium-level education.

They pointed out that such programmes have already been implemented internationally to encourage people to quit their habit as they provide both health and financial benefits.

The researchers noted that an older US study had found financial incentives are 50% more likely to lead to smoking cessation than other types of support.

However, the latest study also observed that it remained unclear which types of reward programmes are better at achieving high quit rates and whether an “optimal” reward schedule could be established or recommended based on when, how often and how much participants should be rewarded.

Data analysed from HSE’s QuitManager system

Researchers analysed data on individuals who used the HSE’s QuitManager system between 2021 and 2023 to log their efforts to give up smoking and calculated quit rates at four, 12, and 53 weeks based on gender, age, and education level.

They also examined three potential incentive schemes all providing a total of €400 to participants but in different amounts at different times.

The most cost-effective reward system was the one which gave an individual €100 on enrolment in the programme and a further €300 if they had still quit smoking 12 months later.

The least cost-effective incentive was a system which offered a series of incremental payments over 12 months ranging from €50 to €200.

However, the study said this payment schedule was also likely to be more successful in the retention of individuals in a financial incentive programme for 52 weeks as regular scheduled payments were more likely to motivate and incentivise participants to quit smoking.

It estimated the cost of rolling out a Fiss scheme to achieve a quit success rate of 50% for the 20,000 people who use the HSE’s stop smoking support programmes could be as low as €2m under the most cost-effective incentive scheme and €4.8m under the least cost-effective method.

One of the main authors of the study, Gintare Valentelyte, said their findings highlighted how Fiss programmes should be targeted at certain social groups to achieve the highest long-term smoking cessation rates.

“The design of the reward schedule has clear trade-offs between the size of the reward and the retention of individuals,” said Dr Valentelyte, a health economist and postdoctoral researcher at RCSI.

The study, which is published in the medical journal, Tobacco Prevention and Cessation, also noted that the acceptability of FISS programmes may differ among stakeholders and was an issue that should be explored further.