Evidence map›Paper›PMID 29791259›Full record

Trial reportThe New England journal of medicine2018

A Pragmatic Trial of E-Cigarettes, Incentives, and Drugs for Smoking Cessation.

Scott D Halpern, Michael O Harhay, Kathryn Saulsgiver, Christine Brophy, Andrea B Troxel, Kevin G Volpp

Registry-linked trialAbstract readComparative StudyMulticenter StudyPragmatic Clinical Trial
PubMed Publisher
In one paragraph

Trial report in The New England journal of medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02328794 (Randomized Clinical Trial to Reduce Harm From Tobacco), which is not on this map. Cited by 116 papers, 18 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
116citing papers in PubMed, 18 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.

NCT02328794 nacompletednot on this map

Randomized Clinical Trial to Reduce Harm From Tobacco

TypeinterventionalSponsorUniversity of PennsylvaniaRan2015 to 2017Enrolled6,006ConditionsSmoking CessationArmsE-cigarette free access, E-cigarette/NRT/Zyban/Chantix Choice, Outcome Incentive arm, Loss framing incentive arm, Control
3 · Its place in the literature

Who cites it

116 citing papers in PubMed, 18 syntheses or guidelines pooled it.

  1. Electronic cigarettes for smoking cessation.The Cochrane database of systematic reviews · 2026
    Pooled it
  2. Pooled it
  3. Electronic cigarettes for smoking cessation.The Cochrane database of systematic reviews · 2025
    Pooled it
  4. Guideline
  5. 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
  6. Electronic cigarettes for smoking cessation.The Cochrane database of systematic reviews · 2025
    Pooled it
  7. Incentives for smoking cessation.The Cochrane database of systematic reviews · 2025
    Pooled it
  8. Electronic cigarettes for smoking cessation.The Cochrane database of systematic reviews · 2024
    Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Electronic cigarettes for smoking cessation.The Cochrane database of systematic reviews · 2022
    Pooled it
  13. Pooled it
  14. Electronic cigarettes for smoking cessation.The Cochrane database of systematic reviews · 2021
    Pooled it
  15. Electronic cigarettes for smoking cessation.The Cochrane database of systematic reviews · 2021
    Pooled it
  16. Pooled it
  17. Electronic cigarettes for smoking cessation.The Cochrane database of systematic reviews · 2020
    Pooled it
  18. Incentives for smoking cessation.The Cochrane database of systematic reviews · 2019
    Pooled it
  19. Trial
  20. Trial

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

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Scott D HalpernFrom the Departments of Medicine (S.D.H., K.G.V.), Medical Ethics and Health Policy (S.D.H., K.G.V.), and Biostatistics, Epidemiology, and Informatics (S.D.H., M.O.H., K.S.), University of Pennsylvania Perelman School of Medicine, the Center for Health Incentives and Behavioral Economics at the Leonard Davis Institute of Health Economics (S.D.H., M.O.H., K.S., A.B.T., K.G.V.), the Palliative and Advanced Illness Research Center (S.D.H., M.O.H.), and the Department of Health Care Management, Wharton School (K.G.V.), University of Pennsylvania, and the Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center (M.O.H., K.G.V.) - all in Philadelphia; and the Vitality Institute (C.B.) and the Division of Biostatistics, New York University Langone Medical Center (A.B.T.) - both in New York.
Michael O HarhayFrom the Departments of Medicine (S.D.H., K.G.V.), Medical Ethics and Health Policy (S.D.H., K.G.V.), and Biostatistics, Epidemiology, and Informatics (S.D.H., M.O.H., K.S.), University of Pennsylvania Perelman School of Medicine, the Center for Health Incentives and Behavioral Economics at the Leonard Davis Institute of Health Economics (S.D.H., M.O.H., K.S., A.B.T., K.G.V.), the Palliative and Advanced Illness Research Center (S.D.H., M.O.H.), and the Department of Health Care Management, Wharton School (K.G.V.), University of Pennsylvania, and the Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center (M.O.H., K.G.V.) - all in Philadelphia; and the Vitality Institute (C.B.) and the Division of Biostatistics, New York University Langone Medical Center (A.B.T.) - both in New York.
Kathryn SaulsgiverFrom the Departments of Medicine (S.D.H., K.G.V.), Medical Ethics and Health Policy (S.D.H., K.G.V.), and Biostatistics, Epidemiology, and Informatics (S.D.H., M.O.H., K.S.), University of Pennsylvania Perelman School of Medicine, the Center for Health Incentives and Behavioral Economics at the Leonard Davis Institute of Health Economics (S.D.H., M.O.H., K.S., A.B.T., K.G.V.), the Palliative and Advanced Illness Research Center (S.D.H., M.O.H.), and the Department of Health Care Management, Wharton School (K.G.V.), University of Pennsylvania, and the Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center (M.O.H., K.G.V.) - all in Philadelphia; and the Vitality Institute (C.B.) and the Division of Biostatistics, New York University Langone Medical Center (A.B.T.) - both in New York.
Christine BrophyFrom the Departments of Medicine (S.D.H., K.G.V.), Medical Ethics and Health Policy (S.D.H., K.G.V.), and Biostatistics, Epidemiology, and Informatics (S.D.H., M.O.H., K.S.), University of Pennsylvania Perelman School of Medicine, the Center for Health Incentives and Behavioral Economics at the Leonard Davis Institute of Health Economics (S.D.H., M.O.H., K.S., A.B.T., K.G.V.), the Palliative and Advanced Illness Research Center (S.D.H., M.O.H.), and the Department of Health Care Management, Wharton School (K.G.V.), University of Pennsylvania, and the Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center (M.O.H., K.G.V.) - all in Philadelphia; and the Vitality Institute (C.B.) and the Division of Biostatistics, New York University Langone Medical Center (A.B.T.) - both in New York.
Andrea B TroxelFrom the Departments of Medicine (S.D.H., K.G.V.), Medical Ethics and Health Policy (S.D.H., K.G.V.), and Biostatistics, Epidemiology, and Informatics (S.D.H., M.O.H., K.S.), University of Pennsylvania Perelman School of Medicine, the Center for Health Incentives and Behavioral Economics at the Leonard Davis Institute of Health Economics (S.D.H., M.O.H., K.S., A.B.T., K.G.V.), the Palliative and Advanced Illness Research Center (S.D.H., M.O.H.), and the Department of Health Care Management, Wharton School (K.G.V.), University of Pennsylvania, and the Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center (M.O.H., K.G.V.) - all in Philadelphia; and the Vitality Institute (C.B.) and the Division of Biostatistics, New York University Langone Medical Center (A.B.T.) - both in New York.
Kevin G VolppFrom the Departments of Medicine (S.D.H., K.G.V.), Medical Ethics and Health Policy (S.D.H., K.G.V.), and Biostatistics, Epidemiology, and Informatics (S.D.H., M.O.H., K.S.), University of Pennsylvania Perelman School of Medicine, the Center for Health Incentives and Behavioral Economics at the Leonard Davis Institute of Health Economics (S.D.H., M.O.H., K.S., A.B.T., K.G.V.), the Palliative and Advanced Illness Research Center (S.D.H., M.O.H.), and the Department of Health Care Management, Wharton School (K.G.V.), University of Pennsylvania, and the Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center (M.O.H., K.G.V.) - all in Philadelphia; and the Vitality Institute (C.B.) and the Division of Biostatistics, New York University Langone Medical Center (A.B.T.) - both in New York.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhether financial incentives, pharmacologic therapies, and electronic cigarettes (e-cigarettes) promote smoking cessation among unselected smokers is unknown.

methodsWe randomly assigned smokers employed by 54 companies to one of four smoking-cessation interventions or to usual care. Usual care consisted of access to information regarding the benefits of smoking cessation and to a motivational text-messaging service. The four interventions consisted of usual care plus one of the following: free cessation aids (nicotine-replacement therapy or pharmacotherapy, with e-cigarettes if standard therapies failed); free e-cigarettes, without a requirement that standard therapies had been tried; free cessation aids plus $600 in rewards for sustained abstinence; or free cessation aids plus $600 in redeemable funds, deposited in a separate account for each participant, with money removed from the account if cessation milestones were not met. The primary outcome was sustained smoking abstinence for 6 months after the target quit date.

resultsAmong 6131 smokers who were invited to enroll, 125 opted out and 6006 underwent randomization. Sustained abstinence rates through 6 months were 0.1% in the usual-care group, 0.5% in the free cessation aids group, 1.0% in the free e-cigarettes group, 2.0% in the rewards group, and 2.9% in the redeemable deposit group. With respect to sustained abstinence rates, redeemable deposits and rewards were superior to free cessation aids (P<0.001 and P=0.006, respectively, with significance levels adjusted for multiple comparisons). Redeemable deposits were superior to free e-cigarettes (P=0.008). Free e-cigarettes were not superior to usual care (P=0.20) or to free cessation aids (P=0.43). Among the 1191 employees (19.8%) who actively participated in the trial (the "engaged" cohort), sustained abstinence rates were four to six times as high as those among participants who did not actively engage in the trial, with similar relative effectiveness.

conclusionsIn this pragmatic trial of smoking cessation, financial incentives added to free cessation aids resulted in a higher rate of sustained smoking abstinence than free cessation aids alone. Among smokers who received usual care (information and motivational text messages), the addition of free cessation aids or e-cigarettes did not provide a benefit. (Funded by the Vitality Institute; ClinicalTrials.gov number, NCT02328794 .).

Indexed as

Electronic Nicotine Delivery SystemsMotivationRewardAdultFemaleHealth PromotionHumansMaleMiddle AgedOccupational Health ServicesSmokingSmoking CessationText MessagingTreatment Outcome

Identifiers

PMID29791259

What OpenQuestion holds

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Read underepoch 390

Registered trials

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.