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Tuesday, October 7, 2008

Prizes don't help smokers kick the habit long-term

By Anne Harding Tuesday, Jul. 22, 2008; 2:26 PM

NEW YORK (Reuters Health) - Contests that offer smokers cash and other incentives to quit don't produce better long-term results than smoking cessation efforts that don't reward people for kicking the habit, a new analysis of existing research demonstrates.

"While competitions may be an attractive and high-profile way of encouraging smokers to make a quit attempt, our evidence found that they don't improve the long-term success rate," Dr. Kate Cahill of the University of Oxford told Reuters Health in an email interview. "Many people relapse once the competition is over and the prizes stop coming."

In the U.S., such contests are typically offered in the workplace, while the highest-profile initiatives outside the U.S. are the international "Quit & Win" contests, run every 2 years in more than 80 countries, Cahill explained.

To investigate whether rewarding smokers improve quit rates, Cahill, and her colleague Dr. Rafael Perera, conducted a review of 17 studies that included about 6,300 people. Every study compared a reward program to a "control" condition, and all verified participants' reports of abstinence with urine, saliva or blood tests. Rewards included things such as lottery tickets and cash.

While some studies showed promising early results, the rate of abstinence 1 or 2 years later among smokers who participated in a reward program was no different from those who weren't rewarded for quitting, the researchers found.

Prizes may not help, Cahill said, but buddy systems, social support and nicotine replacement therapy, bupropion, and varenicline have all been found to improve quitting rates.

It's possible that contests may wind up encouraging more smokers who have been thinking about quitting to give it a try, resulting in a larger number of quitters overall even though success rates don't change, Cahill said.

But, she added, contests may wind up drawing people who are more interested in winning than quitting, and can't always afford to verify people's smoking status at the beginning and the end of the contest. Organizers of a contest in Australia who offered a $10,000 car found that after the competition, a third of participants admitted they were ex-smokers or had never smoked.

SOURCE: Cochrane Database of Systematic Reviews, online July 15, 2008.


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