Financial rewards and guidance to smoking cessation resources increase the rates of smoking cessation significantly in adults who are daily smokers, according to study findings published in JAMA Internal Medicine.

Investigators of this randomized, unblinded, prospective trial assessed the effect of financial incentives and patient guidance on smoking cessation among patients who smoked ≥10 cigarettes/day.

Patients in the intervention group (n=177) were provided financial incentives if smoking cessation was biochemically confirmed at 6 months and 1 year. Additionally, those in the intervention group received guidance to patient resources that aid in smoking cessation. Outcomes were compared with a control group (n=175) that received enhancement to standard care.

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At 1 year, a significantly greater proportion of participants in the intervention group quit smoking compared with the control group (11.9% vs 2.3%, odds ratio, 5.8; 95% CI, 1.9-17.1; number needed to treat, 10.4; P <.001). Financial incentives and patient guidance was specifically beneficial for women (17 [16.8%] vs 2 [2.2%]; P < .001), older participants (19 [19.8%] vs 1 [1.0%]; P < .001), and non-white patients (21 [15.2%] vs 4 [3.0%]; P < .001).

According to the investigators, there are no follow-up data to determine whether cessation at 1 year was associated with long-term lifestyle modifications. In addition, because this study was restricted to 1 urban safety-net hospital with a small number of participants, the researchers are unsure whether these findings are applicable to larger patient populations in other hospital settings.

The investigators of this study were surprised that no white participants in the intervention group quit smoking. “This observation is concerning,” said the investigators, “especially given the recently documented increase in midlife morbidity and mortality among white non-Hispanic women and men in the United States.

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Lasser KE, Quintiliani LM, Truong V, et al. Effect of patient navigation and financial incentives on smoking cessation among primary care patients at an urban safety-net hospital: a randomized clinical trial [published online October 30, 2017]. JAMA Intern Med. doi: 10.1001/jamainternmed.2017.4372