Intended for healthcare professionals


Payment to help quit smoking “works,” says study

BMJ 2012; 344 doi: (Published 10 May 2012) Cite this as: BMJ 2012;344:e3327
  1. Bryan Christie,
  1. 1Edinburgh

A scheme that offers a payment of £12.50 (€15; $20) a week to encourage people living in deprived circumstances to give up smoking is being hailed a success.

A two year evaluation of the quit4u programme in Dundee concludes that it “offers an effective model for engaging and supporting smokers in deprived areas to quit.”

When the scheme was launched in 2009, it was hoped that half of those who took part would give up.1 At one month, the quit rate was 50% compared with 33.7 % for other smoking cessation programmes in Scotland that do not offer a financial incentive. At three months, it was 30.7 % against 14.2 % for other services.

However at 12 months only 9% of those on quit4u were still not smoking, just above the 6.5% rate for other services. The evaluation, carried out by NHS Health Scotland, also acknowledges that there is some uncertainty about the exact size of these 12 month differences because of difficulties in comparing people who were lost to follow-up.

Despite this, the evaluation says the programme is highly cost effective, and Scotland’s public health minister Michael Matheson has recommended it to other Scottish health boards.

Recruitment to quit4u exceeded expectations with just over 2000 people signing up to the programme in the two years from March 2009. The financial incentive paid in supermarket food vouchers after participants passed weekly breath tests to establish that they were not smoking—was considered to be an important factor by only around a third of those taking part.

The financial incentive was paid for a maximum of 12 weeks and was seen as the tipping point or trigger to encourage some people to take part. However, it was the combination of that along with structured behavioural support and access to nicotine replacement therapy that the evaluation says was the key to the success of the programme. The weekly breath tests emerged as an important contributor, helping to motivate and encourage people to stay tobacco free.

The programme cost £2296 for every smoker who had quit at 12 months compared with £1797 in standard NHS smoking cessation services. This is seen as “highly cost effective” compared with the cost of treating smoking related diseases.

NHS Tayside has already extended the scheme in its area and Mr Matheson said: “It’s great news that this project is really helping people in Tayside to give up smoking, and, more importantly, to stop for good. I would encourage other health boards to look to quit4u to see if there are lessons they can learn to increase smoking cessation right across Scotland.”


Cite this as: BMJ 2012;344:e3327



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