Financial incentives for abstinence among socioeconomically disadvantaged individuals in smoking cessation treatment.
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OBJECTIVES: We evaluated the effectiveness of offering adjunctive financial incentives for abstinence (contingency management [CM]) within a safety net hospital smoking cessation program. METHODS: We randomized participants (n=146) from a Dallas County, Texas, Tobacco Cessation Clinic from 2011 to 2013 to usual care (UC; cessation program; n=71) or CM (UC + 4 weeks of financial incentives; n=75), and followed from 1 week before the quit date through 4 weeks after the quit date. A subset (n=128) was asked to attend a visit 12 weeks after the scheduled quit date. RESULTS: Participants were primarily Black (62.3%) or White (28.1%) and female (57.5%). Most participants were uninsured (52.1%) and had an annual household income of less than $12000 (55.5%). Abstinence rates were significantly higher for those assigned to CM than UC at all visits following the quit date (all Ps<.05). Point prevalence abstinence rates in the CM and UC groups were 49.3% versus 25.4% at 4 weeks after the quit date and 32.8% versus 14.1% at 12 weeks after the quit date. CM participants earned an average of $63.40 ($150 possible) for abstinence during the first 4 weeks after the scheduled quit date. CONCLUSIONS: Offering small financial incentives for abstinence might be an effective means to improve abstinence rates among socioeconomically disadvantaged individuals participating in smoking cessation treatment.