Implementation of financial incentives for successful smoking cessation in real-life company settings

Background: Stimulating successful smoking cessation among employees has multiple benefits for companies. Employees who quit tobacco are healthier, more productive, less absent from work, and longer employable than employees who continue to use tobacco. We performed a randomized controlled trial that showed that adding a financial incentive to a smoking cessation group training program in company settings is effective in increasing abstinence rates. The next step is implementing this intervention in real-life, where the funder of the study is no longer paying for the incentives but companies have to pay them themselves.

Methods: We are performing semi-structured qualitative interviews among 20 company managers and 20 (formerly) smoking employees with a low socioeconomic position between January and May 2019. In these interviews, we identify under which conditions the intervention with financial incentives is acceptable and how it could be implemented in real-life. Qualitative data will be analyzed using the Framework Method. After this needs assessment, we will develop an implementation strategy by using Intervention Mapping. Our target group is employees with a low socioeconomic position who smoke tobacco daily.

Results: Our randomized controlled trial showed that the proportion of individuals abstaining from smoking in the intervention group (training program + incentive) was significantly higher than in the control group (training program only) after 12 months: 41% versus 26%, adjusted odds ratio 1.93, 95% CI 1.31-2.85, p=0.0009. At the time of the Lisbon Addictions conference, we will have performed the qualitative interviews and analyzed the data and will have started developing the implementation strategy. Our findings and conclusions for the real-life implementation will be presented at the conference.

Conclusions: Financial incentives in addition to a smoking cessation group training program can significantly increase long-term smoking abstinence. This result alone is not enough to ensure that companies will pay financial incentives for their smoking employees. An implementation strategy is needed to ensure that the intervention is implemented on a large scale. Moreover, effort is needed to ensure that people with a low socioeconomic position take part in the smoking cessation program.