Money is more powerful than a cigarette

Smoking is one of the most common causes of death, mainly with people earning low incomes, as smoking is more frequent in this group. Researchers at the University of Geneva (UNIGE), Switzerland, therefore attempted a new way of inciting smokers to stop smoking using progressive financial rewards, without any medical support or medication. The study extended over an 18-month period with 800 people. Definitely a first! The results, which can be read in the Journal of the American College of Cardiology, revealed the positive impact of financial incentives to stop smoking.

Smoking is the cause of a third of avoidable deaths within the population, meaning deaths which can be prevented if the risk factors are eliminated. To encourage smokers to stop, the team of Jean-François Etter from the UNIGE Faculty of medicine, undertook a groundbreaking experimental study. To test the efficacy of these financial incentives, researchers proposed only money to those wishing to stop smoking, without offering any medical support or medications. But is money alone enough to motivate people to stop smoking?

‘Within this study we had 800 people from the Geneva region whose individual annual income was under 50’000 Swiss Francs, and then we randomly divided them up into two equal-numbered groups. Therefore, the results of the study are expalined by the rewards received by one of the groups instead of other factors related to the panel. The first group received supermarket gift cards if they stopped smoking and the second group received nothing. As Jean-François Etter explained, the largest amount received was set at 1’500 Swiss Francs if the person stopped smoking until the end of the six first months of monitoring.’ To guarantee that the participants really did stop smoking, biochemical tests were carried out after a week, two weeks and three weeks and then after a month, three months and six months. A check was then undertaken 18 months later even when no more financial rewards were distributed. These tests consisted of measuring the level of carbon monoxide and cotinine, a metabolite of nicotine.

The percentage of people who stopped smoking and who received no financial rewards was 12% after three months, 11% after six months and 3.7% after 18 months. However, the percentage of the group who did receive financial rewards were 55% for the first three months, 45% as of the six months and then it dropped to 9.5% at 18 months. So a difference of 5.8% could be noted 1 year after the end of the intervention, which is a similar success rate when using other methods (6% using a combination of medical support and medications, 5% using medications and 5% using just medical advice).

Jean-François Etter added that, ‘The great difference between the percentage of stopping at six months and 18 months leads us to believe that the financial rewards should have been continued over a longer period. We think this could decrease the number of people who will smoke again. Furthermore, combined with medical advice and nicotine substitutes, the success rate could be even higher given the already efficient result with money.’

This study also reaffirmed that rewards (here being financial) allowed to compensate being deprived of an enjoyable behavior (smoking). The ‘right’ attitude, here being to stop smoking, does not stop when the rewards stop, but lasts for a minimum of a year with at least some of the participants. To be as efficient as possible, it is nonetheless important for the reward to be fairly high (hence the 1’500 Swiss Francs), that it is distributed immediately after the desired goal is reached (hence the various steps which are at first very frequent over time and which then slowly fade out), and that the amount increases (here a person first received 100 Francs after a week, 150 Francs after the second week, 200 Francs after the third week, then respectively 300 Francs, 350 Francs and 400 Francs for the following first, third and six months). This study thus reveals that financial rewards can make people stop smoking and that this effect can continue even a year after rewards are distributed.


Jean-François Etter, tél.  +41 22 379 04 59

11 Aug 2016


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