A Cochrane review, in collaboration with the University of Massachusetts Amherst, reveals that offering people a financial incentive is effective in helping them quit smoking and remain smoke-free over time.
For the first time, researchers have also gathered high-certainty evidence showing that this approach works for pregnant people, opening new possibilities for people looking to avoid medications as much as possible during their pregnancy.
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New Evidence Supports Long-Term Quitting Success
Drawing from 47 studies that included almost 22000 participants across the United States, South Africa, Europe and Southeast Asia the review shows that financial inducements— which range from small gift vouchers to larger cash sums—boost quitting rates and help people stay off cigarettes.
“It’s not that these people could have quit anyway and decided to do so because of the money,” explains senior author Jamie Hartmann-Boyce of UMass Amherst. “A lot of people in these studies had tried to quit many times before and couldn’t until this extra motivation helped.”
High-Certainty Findings for Pregnant Participants
The updated review sheds light on an especially important group: pregnant people. Previous research offered moderate assurance that financial incentives could improve quitting rates in pregnancy. Now, this new evidence provides high-certainty findings. Out of every 100 pregnant individuals who received incentives, 13 quit smoking successfully, compared to only 6 out of 100 who did not receive similar rewards.
“Smoking during pregnancy can be harmful to both parent and fetus,” says Hartmann-Boyce. “Many want to avoid using stop-smoking medications, so having additional, safe options is crucial.”
More on smoking: Ten myths about smoking that will not die - (Universal-Sci)
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Addressing Concerns and Expanding Access
Some worry that offering rewards encourages “bad behaviour.” However, experts highlight that incentives work by tapping into the brain’s reward systems, a key factor in addiction. Beyond smoking cessation, programs using this method—often called “contingency management”—have shown promise for treating stimulant use disorders.
California pioneered an initiative to cover incentives through Medicaid, and at least 14 other states have followed suit. Lead author Caitlin Notley of the University of East Anglia says these programs are becoming more accepted, explaining, “We are now very confident that incentives help people, and pregnant people too, to quit smoking better than not offering incentives.”
By combining financial incentives with established supports like counselling and quitlines, more individuals may finally find success in giving up cigarettes. For those who have struggled to quit, the evidence is clearer than ever: offering tangible rewards can provide the boost needed to overcome nicotine addiction.
If you are interested in more details about the underlying study, check out the paper published in the peer-reviewed journal 'Cochrane Database of Systematic Reviews' listed below this article.
Sources and further reading:
Incentives for Smoking Cessation (Cochrane Database of Systematic Reviews)
Ten myths about smoking that will not die (Universal-Sci)
Young 'night owls' are prone to drinking and smoking due to impulsiveness (Universal-Sci)
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