How Financial Incentives Increase Smoking Cessation: A Two-Level Path Analysis

Abstract Introduction Financial incentives effectively increase smoking cessation rates, but it is unclear via which psychological mechanisms incentives influence quit behavior. The current study examines how receiving financial incentives for smoking cessation leads to quitting smoking and investigates several mediators and moderators of that relationship. Aims and Methods The study sample consisted of 604 tobacco-smoking employees from 61 companies in the Netherlands who completed a baseline and follow-up questionnaire. The current study is a secondary analysis from a cluster randomized trial where employees received smoking cessation group counseling at the workplace. Participants in the intervention group additionally received financial incentives of €350 in total for 12-month continuous smoking abstinence. We used a two-level path analysis to test a model that assesses the effects of financial incentives through smoking cessation program evaluation, medication use, nicotine replacement use, attitudes, self-efficacy, and social influences on quit success. We additionally tested whether an individual’s reward responsiveness moderated the influence of incentives on quit success. Results The effect of financial incentives on quit success was mediated by a higher self-efficacy. Financial incentives were also associated with a higher use of cessation medication. A more positive program evaluation was related to higher self-efficacy, more social influence to quit, and more positive attitudes about quitting. The results did not differ significantly by individual reward responsiveness. Conclusions The results of the current study suggest that financial incentives may be used to increase medication use and self-efficacy for quitting smoking, which offers an indirect way to increase successful smoking cessation. Implications (1) This is the first study investigating via which psychological pathways financial incentives for quitting smoking can lead to long-term quit success. (2) The results showed a path between financial incentives and a higher likelihood of medication use. Incentives may encourage smokers to use medication in order to increase their chance of quitting smoking and receive the reward. (3) There was a path from financial incentives to quit success via a higher self-efficacy. (4) The effects of financial incentives did not depend on individual reward responsiveness.

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‘Quit and Stay Quit Monday’ as a Novel Approach to Smoking Cessation: A Pilot Experimental Study

The Journal of Smoking Cessation ◽

10.1017/jsc.2017.14 ◽

2017 ◽

Vol 13 (3) ◽

pp. 171-175

Author(s):

Elaine De Leon ◽

Norah L. Crossnohere ◽

Laura W. Fuentes ◽

Morgan Johnson ◽

Kevin Welding ◽

...

Keyword(s):

Smoking Cessation ◽

Information Seeking ◽

Self Efficacy ◽

Intervention Group ◽

Standard Group ◽

Novel Approach ◽

Quitting Smoking ◽

Quasi Experimental ◽

Behaviour Changes

Introduction:Emerging evidence suggests a heightened interest in healthy behaviour changes, including smoking cessation, at the beginning of the week. Evidence from Google searches, quitlines, and cessation websites show greater information-seeking and interest in early week quitting.Aims:This pilot assesses the comparative effectiveness of a smoking cessation intervention that encourages participants to use Mondays as a day to quit or recommit to quitting smoking.Methods:We partnered with existing smoking cessation group programs to conduct a quasi-experimental, pre–post study. Both comparison and intervention groups received the same standard-care curriculum from program instructors. Intervention group participants received Monday materials including a wallet card and a mantra card during enrolment. On Mondays, intervention participants received an emailed tip-of-the-week and were encouraged to quit or recommit to quitting. Quit buddies were recommended in both groups, but intervention participants were encouraged to check-in with quit buddies on Mondays. The outcomes of smoking abstinence, number and length of quit attempts, and self-efficacy were assessed at the final program session and three months later.Results:At the last session, intervention group participants who were still smoking had a higher self-efficacy of quitting in the future, rated their programs as more helpful in quitting smoking, and were more likely to rate quit buddies as very helpful. Differences in self-efficacy were no longer observed at the second follow-up. No differences were observed between intervention and standard group participants in abstinence, number of quits, length of quits, or self-efficacy of staying quit at either follow-up.Conclusions:Encouraging results from this pilot study indicate that further research is needed to explore how Monday messaging may improve smoking cessation programs.

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Changes in self-efficacy associated with success in quitting smoking in participants in Japanese smoking cessation therapy

International Journal of Nursing Practice ◽

10.1111/ijn.12647 ◽

2018 ◽

Vol 24 (4) ◽

pp. e12647 ◽

Cited By ~ 4

Author(s):

Chie Taniguchi ◽

Hideo Tanaka ◽

Hideo Saka ◽

Isao Oze ◽

Kazunobu Tachibana ◽

...

Keyword(s):

Smoking Cessation ◽

Self Efficacy ◽

Quitting Smoking ◽

Smoking Cessation Therapy

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Smoking cessation in cardiac patients: the influence of action plans, coping plans and self-efficacy on quitting smoking

Health Education Research ◽

10.1093/her/cyv100 ◽

2016 ◽

Vol 31 (3) ◽

pp. 350-362 ◽

Cited By ~ 6

Author(s):

Natascha de Hoog ◽

Catherine Bolman ◽

Nadine Berndt ◽

Esther Kers ◽

Aart Mudde ◽

...

Keyword(s):

Smoking Cessation ◽

Self Efficacy ◽

Cardiac Patients ◽

Action Plans ◽

Quitting Smoking

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Predictors of Smoking Cessation in a Lifestyle-Focused Text-Message Support Programme Delivered to People with Coronary Heart Disease: An Analysis From the Tobacco Exercise and Diet Messages (TEXTME) Randomised Clinical Trial

Tobacco Use Insights ◽

10.1177/1179173x20901486 ◽

2020 ◽

Vol 13 ◽

pp. 1179173X2090148

Author(s):

Harry Klimis ◽

Simone Marschner ◽

Amy Von Huben ◽

Aravinda Thiagalingam ◽

Clara K Chow

Keyword(s):

Smoking Cessation ◽

Text Messaging ◽

A Priori ◽

Univariate Analysis ◽

Intervention Group ◽

Text Message ◽

Prevention Programs ◽

Text Messages ◽

Baseline Risk ◽

Quitting Smoking

Background: Studies have demonstrated the effectiveness of text message-based prevention programs on smoking cessation, including our recently published TEXTME randomised controlled trial. However, little is known about the predictors of smoking cessation in this context and if other clinically important factors interact with the program to lead to quitting. Hence, the objective of this study was to first assess the predictors of smoking cessation in TEXTME and then determine if the effect of texting on quitting was modified by interactions with important clinical variables. This will allow us to better understand how text messaging works and thus help optimise future text-message based prevention programs. Methods This sub-analysis used data collected as part of the TEXTME trial which recruited 710 participants (377 current smokers at baseline) between September 2011 and November 2013 from a large tertiary hospital in Sydney, Australia. Smokers at baseline were analysed at 6 months and grouped into those who quit and those who did not. Univariate analyses were performed to determine associations between the main outcome and clinically important baseline factors selected a priori. A multiple binominal logistic regression analysis was conducted to develop a predictive model for the dependent variable smoking cessation. A test of interaction between the intervention group and baseline variables selected a priori with the outcome smoking cessation was performed. Results Univariate analysis identified receiving text-messages, age, and mean number of cigarettes smoked each day as being associated with quitting smoking. After adjusting for age, receiving the text-messaging program (OR 2.34; 95%CI 1.43-3.86; p<0.01) and mean number of cigarettes smoked per day (OR 1.02; 95%CI 1.00-1.04; p=0.03) were independent predictors for smoking cessation. LDL-C showed a significant interaction effect with the intervention (High LDL*Intervention OR 3.77 (95%CI 2.05-6.94); Low LDL*Intervention OR 1.42 (95%CI 0.77-2.60); P=0.03). Conclusions Smoking quantity at baseline is independently associated with smoking cessation and higher LDL-C may interact with the intervention to result in quitting smoking. Those who have a higher baseline risk maybe more motivated towards beneficial lifestyle change including quitting smoking, and thus more likely to respond to mHealth smoking cessation programs. The effect of text-messages on smoking cessation was independent of age, gender, psychosocial parameters, education, and baseline control of risk factors in a secondary prevention cohort.

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Explorations of Self-Efficacy: Personal Narratives as Qualitative Data in the Analysis of Smoking Cessation Efforts

The Journal of Smoking Cessation ◽

10.1375/jsc.5.1.57 ◽

2010 ◽

Vol 5 (1) ◽

pp. 57-68 ◽

Cited By ~ 2

Author(s):

Erin Rollins ◽

Jenepher Lennox Terrion

Keyword(s):

Smoking Cessation ◽

Narrative Analysis ◽

Self Efficacy ◽

Personal Narratives ◽

Past Research ◽

Smoking Intervention ◽

Smoking Cessation Counselling ◽

Cardiovascular Patients ◽

Quitting Smoking ◽

Readiness To Quit

AbstractResearch has found that an individual's perceived self-efficacy, supported by goals and the acceptance of potential obstacles, has the ability to assist in behaviour modification. By examining the narratives of cardiovascular patients undergoing smoking cessation counselling, this study highlights factors that individuals communicate in their narratives regarding changes to self-efficacy throughout the process of smoking cessation. Narrative analysis is used to establish those factors that cardiovascular patients assert to be the motivating or impeding factors in their smoking cessation efforts, particularly in relation to their initial readiness to quit smoking. The study's findings illustrate the social, physical and psychological barriers and motivating factors that exist for cardiovascular patients in the process of quitting smoking. The current study supplements past research illustrating that in-hospital programs are among the most influential smoking intervention strategies because they can be tailored to each patient's specific health problems and personal and social circumstances. The study concludes that the relationship formed between patients and intervention specialists can assist in raising an individual's self-efficacy to end an addictive behaviour.

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Effect of quitting smoking on health outcomes during treatment for tuberculosis: secondary analysis of the TB & Tobacco Trial

Thorax ◽

10.1136/thoraxjnl-2020-215926 ◽

2021 ◽

pp. thoraxjnl-2020-215926

Author(s):

Kamran Siddiqi ◽

Ada Keding ◽

Anna-Marie Marshall ◽

Omara Dogar ◽

Jinshuo Li ◽

...

Keyword(s):

Quality Of Life ◽

Smoking Cessation ◽

Health Outcomes ◽

Secondary Analysis ◽

Completion Rates ◽

Tb Treatment ◽

Quitting Smoking ◽

Sputum Conversion ◽

Relapse Rates

BackgroundDespite treatment, patients with tuberculosis (TB) who smoke have poorer outcomes compared with non-smokers. It is unknown, however, if quitting smoking during the 6 months of TB treatment improves TB outcomes.MethodsThe TB & Tobacco Trial was a double-blind, placebo-controlled randomised trial of cytisine for smoking cessation in 2472 patients with pulmonary TB in Bangladesh and Pakistan. In a secondary analysis, we investigated the hypothesis that smoking cessation improves health outcomes in patients during the TB treatment course. The outcomes included an eight-point TB clinical score, sputum conversion rates, chest X-ray grades, quality of life (EQ-5D-5L), TB cure plus treatment completion rates and relapse rates. These were compared between those who stopped smoking and those who did not, using regression analysis.ResultsWe analysed the data of 2273 (92%) trial participants. Overall, 25% (577/2273) of participants stopped smoking. Compared with non-quitters, those who quit had better TB cure plus treatment completion rates (91% vs 80%, p<0.001) and lower TB relapse rates (6% vs 14%, p<0.001). Among quitters, a higher sputum conversion rate at week 9 (91% vs 87%, p=0.036), lower mean TB clinical scores (−0.20 points, 95% CI −0.31 to −0.08, p=0.001) and slightly better quality of life (mean EQ-5D-5L 0.86 vs 0.85, p=0.015) at 6 months were also observed. These differences, except quality of life, remained statistically significant after adjusting for baseline values, trial arm and TB treatment adherence rates.ConclusionPatients with TB who stop smoking may have better outcomes than those who don’t. Health professionals should support patients in stopping smoking.

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Correlated Factors with Quitting Attempts Among Male Smokers in Vietnam: A QUITLINE-Based Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16010084 ◽

2018 ◽

Vol 16 (1) ◽

pp. 84 ◽

Cited By ~ 1

Author(s):

Chau Ngo ◽

Ryan Chiu ◽

Hanh Chu ◽

Giap Vu ◽

Quang Nguyen ◽

...

Keyword(s):

Smoking Cessation ◽

Self Efficacy ◽

Associated Factors ◽

Economic Status ◽

Tobacco Consumption ◽

Cross Sectional Study ◽

Smoking History ◽

Cross Sectional ◽

Rural And Urban ◽

Quitting Smoking

Despite its decreasing prevalence, cigarette smoking remains the second leading cause of preventable death worldwide. In Vietnam, despite recent smoking cessation efforts, the prevalence of tobacco consumption remains high, particularly among males. In this study, we aim to evaluate the self-efficacy in quitting smoking (i.e., quitting confidence), intention to quit, and identifying associated factors among both rural and urban Vietnamese male populations. A cross-sectional study was conducted on 321 patients (52.7% urban and 47.4% rural inhabitants) who utilized QUITLINE services of Bach Mai Hospital (Hanoi, Vietnam). Socio-economic status, smoking history, cigarette usage data, and intent to quit were assessed. Baseline data were correlated with quitting confidence, to identify significant associated factors. The majority (75.9%) of participants were in the planning phase of cessation, yet 90.8% lacked complete confidence in their quitting ability. Older age, fewer cigarettes per day and previous quitting attempts were associated with quitting confidence (p < 0.05) and plans to quit (p < 0.05). Older smokers and previous quitters were more confident in their ability to quit in the near future and more likely to have made plans to quit. Future smoking cessation efforts should focus on improving self-efficacy, particularly among younger and newer smokers.

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Remote Patient Monitoring and Incentives to Support Smoking Cessation Among Pregnant and Postpartum Medicaid Members: Three Randomized Controlled Pilot Studies

JMIR Formative Research ◽

10.2196/27801 ◽

2021 ◽

Vol 5 (9) ◽

pp. e27801

Author(s):

Caroline M Joyce ◽

Kathryn Saulsgiver ◽

Salini Mohanty ◽

Chethan Bachireddy ◽

Carin Molfetta ◽

...

Keyword(s):

Smoking Cessation ◽

Pilot Study ◽

Birth Outcomes ◽

Low Income ◽

Remote Monitoring ◽

Financial Incentives ◽

Intervention Group ◽

Health Care Expenditures ◽

Similar Reduction ◽

Pregnant Smokers

Background Smoking rates among low-income individuals, including those eligible for Medicaid, have not shown the same decrease that is observed among high-income individuals. The rate of smoking among pregnant women enrolled in Medicaid is almost twice that among privately insured women, which leads to significant disparities in birth outcomes and a disproportionate cost burden placed on Medicaid. Several states have identified maternal smoking as a key target for improving birth outcomes and reducing health care expenditures; however, efficacious, cost-effective, and feasible cessation programs have been elusive. Objective This study aims to examine the feasibility, acceptability, and effectiveness of a smartwatch-enabled, incentive-based smoking cessation program for Medicaid-eligible pregnant smokers. Methods Pilot 1 included a randomized pilot study of smartwatch-enabled remote monitoring versus no remote monitoring for 12 weeks. Those in the intervention group also received the SmokeBeat program. Pilot 2 included a randomized pilot study of pay-to-wear versus pay-to-quit for 4 weeks. Those in a pay-to-wear program could earn daily incentives for wearing the smartwatch, whereas those in pay-to-quit program could earn daily incentives if they wore the smartwatch and abstained from smoking. Pilot 3, similar to pilot 2, had higher incentives and a duration of 3 weeks. Results For pilot 1 (N=27), self-reported cigarettes per week among the intervention group declined by 15.1 (SD 27) cigarettes over the study; a similar reduction was observed in the control group with a decrease of 17.2 (SD 19) cigarettes. For pilot 2 (N=8), self-reported cigarettes per week among the pay-to-wear group decreased by 43 cigarettes (SD 12.6); a similar reduction was seen in the pay-to-quit group, with an average of 31 (SD 45.6) fewer cigarettes smoked per week. For pilot 3 (N=4), one participant in the pay-to-quit group abstained from smoking for the full study duration and received full incentives. Conclusions Decreases in smoking were observed in both the control and intervention groups during all pilots. The use of the SmokeBeat program did not significantly improve cessation. The SmokeBeat program, remote cotinine testing, and remote delivery of financial incentives were considered feasible and acceptable. Implementation challenges remain for providing evidence-based cessation incentives to low-income pregnant smokers. The feasibility and acceptability of the SmokeBeat program were moderately high. Moreover, the feasibility and acceptability of remote cotinine testing and the remotely delivered contingent financial incentives were successful. Trial Registration ClinicalTrials.gov NCT03209557; https://clinicaltrials.gov/ct2/show/NCT03209557.

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Using Mass Media Communications to Promote Smoking Cessation in Turkey and Post-test Measurement

Journal of Global Oncology ◽

10.1200/jgo.18.54300 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 139s-139s

Author(s):

M.P.T. Durgut

Keyword(s):

Smoking Cessation ◽

Behavioral Change ◽

Self Efficacy ◽

Web Site ◽

Target Audience ◽

Perceived Benefits ◽

Quit Smoking ◽

Quitting Smoking ◽

Promote Smoking Cessation ◽

The Web

Background and context: In 2017 March, Turkey has launched a public campaign to promote smoking cessation among adults. The purpose of the campaign is to create awareness about the risks and health effects of cigarette smoking and to promote behavioral change, based on health behavior model (HBM.) Aim: To encourage behavioral change by decreasing perceived benefits of smoking and increasing perception of threat related to smoking among the target audience. decreasing perception of barrier related to behavioral change and increase sense of self-efficacy among the target audience Strategy/Tactics: · Three television advertisements aiming to increase perceived threat of smoking and to increase perceived benefits of quitting · Two radio advertisements aiming to increase self-efficacy to quit, · Web portal ( birakabilirsin.org ) aiming to increase self-efficacy to quit Outcomes: After the ad campaign, a quantitative survey was carried out aiming to measure the attitude about the key messages of the campaign and intention to quit smoking. The survey was conducted in October-November 2017 and used the in-person household survey method to reach samples of current cigarette smokers, ex-smokers and nonsmokers in Turkey aged 18 years and above (planned sample size is 1700). According to the results of the postcampaign evaluation, the messages of the campaign were retained with a high 85.5% Nearly half of those saying they quit after the campaign started declared that the campaign was effective in helping them quit smoking. 48% of those quit said that the campaign helped them to not restart smoking. 80% of those who never smoked stated that the campaign decreased their desire to try smoking. Half of the survey participants heard of the campaign Web site 7% of the people who heard of the Web site visited it. 68% of the participants who visited the Web site believed that the Web site would help in quitting smoking. What was learned: The results of the postcampaign evaluation show that the campaign was successful in establishing perceived risk of smoking, changing perception and attitudes and developing the intention of quitting smoking among the target population. The campaign also helped people to actually quit smoking. The mandated free publication of antitobacco PSAs in all local and national channels according to the Turkish Tobacco Control Laws positively affected the public access of the campaign.

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A Comparison of Users and Nonusers of a Web-Based Intervention for Carers of Older Persons With Alzheimer Disease and Related Dementias: Mixed Methods Secondary Analysis

Journal of Medical Internet Research ◽

10.2196/14254 ◽

2019 ◽

Vol 21 (10) ◽

pp. e14254 ◽

Cited By ~ 4

Author(s):

Wendy Duggleby ◽

Jenny Ploeg ◽

Carrie McAiney ◽

Kathryn Fisher ◽

Kathya Jovel Ruiz ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Mixed Methods ◽

Self Efficacy ◽

Computer Literacy ◽

Controlled Trial ◽

Intervention Group ◽

Secondary Analysis ◽

Web Based ◽

Telephone Interviews ◽

Randomized Controlled

Background A self-administered Web-based intervention was developed to help carers of persons with Alzheimer disease and related dementias (ADRD) and multiple chronic conditions (MCC) deal with the significant transitions they experience. The intervention, My Tools 4 Care (MT4C), was evaluated during a pragmatic mixed methods randomized controlled trial with 199 carers. Those in the intervention group received free, password-protected access to MT4C for three months. MT4C was found to increase hope in participants at three months compared with the control group. However, in the intervention group, 22% (20/92) did not use MT4C at all during the three-month period. Objective This mixed methods secondary analysis aimed to (1) examine differences at three months in the outcomes of hope, self-efficacy, and health-related quality of life (HRQOL) scores in users (ie, those who used MT4C at least once during the three-month period) compared with nonusers and (2) identify reasons for nonuse. Methods Data from the treatment group of a pragmatic mixed methods randomized controlled trial were used. Through audiotaped telephone interviews, trained research assistants collected data on participants’ hope (Herth Hope Index; HHI), self-efficacy (General Self-Efficacy Scale; GSES), and HRQOL (Short-Form 12-item health survey version 2; SF-12v2) at baseline, one month, and three months. Treatment group participants also provided feedback on MT4C through qualitative telephone interviews at one month and three months. Analysis of covariance was used to determine differences at three months, and generalized estimating equations were used to determine significant differences in HHI, GSES, and SF-12v2 between users and nonusers of MT4C from baseline to three months. Interview data were analyzed using content analysis and integrated with quantitative data at the result stage. Results Of the 101 participants at baseline, 9 (9%) withdrew from the study, leaving 92 participants at three months of which 72 (78%) used MT4C at least once; 20 (22%) participants did not use it at all. At baseline, there were no statistically significant differences in demographic characteristics and in outcome variables (HHI, GSES, and SF-12v2 mental component score and physical component score) between users and nonusers. At three months, participants who used MT4C at least once during the three-month period (users) reported higher mean GSES scores (P=.003) than nonusers. Over time, users had significantly higher GSES scores than nonusers (P=.048). Reasons for nonuse of MT4C included the following: caregiving demands, problems accessing MT4C (poor connectivity, computer literacy, and navigation of MT4C), and preferences (for paper format or face-to-face interaction). Conclusions Web-based interventions, such as MT4C, have the potential to increase the self-efficacy of carers of persons with ADRD and MCC. Future research with MT4C should consider including educational programs for computer literacy and providing alternate ways to access MT4C in addition to Web-based access. Trial Registration ClinicalTrials.gov NCT02428387; https://clinicaltrials.gov/ct2/show/NCT02428387

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