Want to Quit Smoking? Care to Make It Interesting?

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Giving up cigarettes is one of the best things you can do for your body. Yet quitting is notoriously hard—and smoking still remains one of the largest risk factors for cancer and other diseases. Could gambling be the answer?

That’s the suggestion of a recent study by researchers from the Perelman School of Medicine and Wharton. In a comparison of several incentivized smoking-cessation programs, they hit on a scheme that drastically improved quitting rates: coaxing participants into wagering on their ability to succeed.

The study, published in the New England Journal of Medicine in May, assessed the effectiveness of various incentives designed to get smokers to quit. Financial incentives have been shown to make a difference before, and that held true. Overall, about 17 percent of participants offered $800 to quit succeeded in doing so for six months—roughly triple the rate of non-incentivized smokers.

But the results were even more striking for a group offered slightly different terms: if they made a $150 refundable deposit, and stopped smoking for six months, they could win it back, plus an additional $650. Among participants who accepted that challenge, an eye-popping 52 percent quit.

Yet there was a wrinkle that dampened the researcher’s excitement: only 14 percent of the people offered that deal accepted it. “On net,” according to co-author Kevin Volpp, a professor of medicine and director of the Center for Health Incentives and Behavioral Economics at Penn’s Leonard Davis Institute, “that was less effective than simply giving people a standard incentive in which if they quit smoking, they would get up to $800.”

Nevertheless, the study underlines an important point. “An incentive is not an incentive; a dollar is not a dollar,” as Volpp put it. “It all depends on how these programs are designed, how they’re delivered.”

Volpp plans a follow-up experiment testing ways to coax more people into wagering on their ability to quit. “One of the key areas going forward,” he said, “is how to increase that 14 percent.”

Luke Hoban C’17

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