Evidence map›Paper›PMID 25970009›Full record

Trial reportThe New England journal of medicine2015

Randomized trial of four financial-incentive programs for smoking cessation.

Scott D Halpern, Benjamin French, Dylan S Small, Kathryn Saulsgiver, Michael O Harhay, Janet Audrain-McGovern, George Loewenstein, Troyen A Brennan, David A Asch, Kevin G Volpp

7 registry-linked trialsAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The New England journal of medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 7 registered trials, which are not on this map. Cited by 192 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
192citing papers in PubMed, 16 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01526265 nacompletednot on this map

Way to Quit - Comparative Efficacy, Acceptance and Effectiveness of Health Incentive Structures

TypeinterventionalSponsorUniversity of PennsylvaniaRan2012 to 2015Enrolled2,185ConditionsTobacco Use DisorderArmsUsual Care, Individual Rewards, Fixed Deposits, Competitive Deposits (Pari-Mutuel), Collaborative Rewards
NCT02548182 naunknown statusnot on this map

Enhancing Physical Activity and Weight Reduction Through Smartcare and Financial Incentives: A Pilot Randomized Controlled Trial

TypeinterventionalSponsorSeoul National University HospitalRan2015 to 2015Enrolled105ConditionsObesityArmssmartcare, financial incentives
NCT03090646 naterminatednot on this mapstarted 2017, after this paper: background citation

Use of Financial Incentives to Increase Live Kidney Donor Follow-up Compliance

TypeinterventionalSponsorJohns Hopkins UniversityRan2017 to 2024Enrolled140ConditionsLiving Donors, Nephrectomy, KidneyArmsFinancial Incentive
NCT03338829 nacompletednot on this mapstarted 2016, after this paper: background citation

Incentive Models on Testing Adherence for Women With Diabetes During Pregnancy

TypeinterventionalSponsorUniversity of IowaRan2016 to 2022Enrolled130ConditionsDiabetes in PregnancyArmsPositive incentive, Loss aversion
NCT03507231 nacompletednot on this mapstarted 2017, after this paper: background citation

Non-integrated Costs Increase Effectiveness of Incentives

TypeinterventionalSponsorCarnegie Mellon UniversityRan2017 to 2018Enrolled12,531ConditionsControl - No Incentive for Flu Vaccine, Direct Incentive, Indirect IncentiveArmsEmail Message, Incentive for Vaccination, Incentive for completing a short survey
NCT03833219 nacompletednot on this mapstarted 2019, after this paper: background citation

Comparative Effectiveness of Financial Incentives and Smartphone-based Nudges to Reduce Cellphone Use While Driving Among Auto Insurance Policy Holders With Usage Based Insurance Policies

TypeinterventionalSponsorUniversity of PennsylvaniaRan2019 to 2020Enrolled2,108ConditionsAutomobile AccidentArmsWeekly feedback, End of intervention period incentive, Loss-framed weekly incentive
NCT04458766 nacompletednot on this mapstarted 2021, after this paper: background citation

The Use of Mobile Health Technology and Behavioral Economics to Encourage Adherence to Statins in Adolescents With Familial Hypercholesterolemia

TypeinterventionalSponsorBoston Children's HospitalRan2021 to 2024Enrolled11ConditionsFamilial Hypercholesterolemia, Adherence, MedicationArmsMonetary incentives
3 · Its place in the literature

Who cites it

192 citing papers in PubMed, 16 syntheses or guidelines pooled it.

  1. Guideline
  2. Financial Incentives for Substance Abstinence: A Systematic Review and Meta-analysis.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025
    Pooled it
  3. Pooled it
  4. Pooled it
  5. Incentives for smoking cessation.The Cochrane database of systematic reviews · 2025
    Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Impacts of new cycle infrastructure on cycling levels in two French cities: an interrupted time series analysis.The international journal of behavioral nutrition and physical activity · 2022
    Pooled it
  10. Pooled it
  11. Pooled it
  12. Incentives for smoking cessation.The Cochrane database of systematic reviews · 2019
    Pooled it
  13. Competitions for smoking cessation.The Cochrane database of systematic reviews · 2019
    Pooled it
  14. Enhancing partner support to improve smoking cessation.The Cochrane database of systematic reviews · 2018
    Pooled it
  15. Pooled it
  16. Pooled it
  17. The impact of learning about financial compensation on enrollment in Alzheimer's disease longitudinal research.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Trial
  18. Trial
  19. Trial
  20. Trial

132 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Scott D HalpernFrom the Departments of Medicine (S.D.H., D.A.A., K.G.V.), Biostatistics and Epidemiology (S.D.H., B.F., K.S., M.O.H.), Medical Ethics and Health Policy (S.D.H., K.G.V.), and Psychiatry (J.A.-M.) and the Center for Health Incentives and Behavioral Economics at the Leonard Davis Institute of Health Economics (S.D.H., B.F., D.S.S., K.S., J.A.-M., G.L., D.A.A., K.G.V.), Perelman School of Medicine at the University of Pennsylvania, the Departments of Statistics (D.S.S.) and Health Care Management (D.A.A., K.G.V.), Wharton School, University of Pennsylvania Center for Health Equity Research and Promotion, the Philadelphia Veterans Affairs Medical Center (D.A.A., K.G.V.), and the Center for Health Care Innovation, University of Pennsylvania Health System (D.A.A., K.G.V.) - all in Philadelphia; the Center for Behavioral Decision Research, Carnegie Mellon University, Pittsburgh (G.L.); and CVS Caremark, Woonsocket, RI (T.A.B.).
Benjamin French
Dylan S Small
Kathryn Saulsgiver
Michael O Harhay
Janet Audrain-McGovern
George Loewenstein
Troyen A Brennan
David A Asch
Kevin G Volpp

Funding

The Penn Roybal Center on Behavioral Economics and Health: Solving for Scale and Impact with Design Thinking, Digital Platforms, and Dynamic AdaptationP30AG034546 · NIA · UNIVERSITY OF PENNSYLVANIA · PI Alison Meredith Buttenheim · 2009 to 2026
$10.6M
Developing Interactive Technologies to Improve Research and Health BehaviorRC2AG036592 · NIA · UNIVERSITY OF PENNSYLVANIA · PI ASCH, DAVID A, VOLPP, KEVIN G · 2009 to 2010
$5.4M
Comparative Efficacy, Acceptance and Effectiveness of Health Incentive StructuresR01CA159932 · NCI · UNIVERSITY OF PENNSYLVANIA · PI HALPERN, SCOTT D · 2010 to 2014
$3.0M
NCI NIH HHS R01 CA159932NIA NIH HHS P30 AG034546NIA NIH HHS RC2 AG036592
6 · The paper itself

Abstract

backgroundFinancial incentives promote many health behaviors, but effective ways to deliver health incentives remain uncertain.

methodsWe randomly assigned CVS Caremark employees and their relatives and friends to one of four incentive programs or to usual care for smoking cessation. Two of the incentive programs targeted individuals, and two targeted groups of six participants. One of the individual-oriented programs and one of the group-oriented programs entailed rewards of approximately $800 for smoking cessation; the others entailed refundable deposits of $150 plus $650 in reward payments for successful participants. Usual care included informational resources and free smoking-cessation aids.

resultsOverall, 2538 participants were enrolled. Of those assigned to reward-based programs, 90.0% accepted the assignment, as compared with 13.7% of those assigned to deposit-based programs (P<0.001). In intention-to-treat analyses, rates of sustained abstinence from smoking through 6 months were higher with each of the four incentive programs (range, 9.4 to 16.0%) than with usual care (6.0%) (P<0.05 for all comparisons); the superiority of reward-based programs was sustained through 12 months. Group-oriented and individual-oriented programs were associated with similar 6-month abstinence rates (13.7% and 12.1%, respectively; P=0.29). Reward-based programs were associated with higher abstinence rates than deposit-based programs (15.7% vs. 10.2%, P<0.001). However, in instrumental-variable analyses that accounted for differential acceptance, the rate of abstinence at 6 months was 13.2 percentage points (95% confidence interval, 3.1 to 22.8) higher in the deposit-based programs than in the reward-based programs among the estimated 13.7% of the participants who would accept participation in either type of program.

conclusionsReward-based programs were much more commonly accepted than deposit-based programs, leading to higher rates of sustained abstinence from smoking. Group-oriented incentive programs were no more effective than individual-oriented programs. (Funded by the National Institutes of Health and CVS Caremark; ClinicalTrials.gov number, NCT01526265.).

Indexed as

RewardAdultFemaleGroup ProcessesHumansMaleMiddle AgedMotivationSmoking Cessation

Identifiers

PMID25970009
PMCPMC4471993

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.