Does cash incentive reduce smoking?

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1. 1

   Features of smoking cessation, alcohol reduction, and diet and physical activity interventions associated with changing behaviours during pregnancy: a systematic review of reviews.

   Journal of behavioral medicine (Newham et al.)Published Aug 6, 2026Checked Oct 3, 2026

   “The search strategy covered reviews published between 2013 and 2025 and identified 66 reviews (9 smoking, 6 alcohol, 50 diet/PA, 1 smoking, diet, and/or PA). Diet/PA interventions should begin in the first trimester, run for a longer duration, and entail frequent engagement via a range of modalities in a supervised format (ideally from a specialist provider). Smoking intervention effectiveness was consistently associated with incentives and counselling. Brief interventions were consistently reported as effective interventions for alcohol use but there was a lack of standardisation in delivery. BCTs from the "goals and planning" and "feedback and monitoring" domains were routinely associated with effectiveness. Further research is required to explore intervention features that have shown promise in one behaviour but have yet to be tested for other behaviours, such as incentives in alcohol interventions.”

2. 2

   Financial incentives for maintaining postpartum smoking abstinence: 3-4-year follow-up of the Financial Incentives for Prevention of Postpartum Return to Smoking (FIPPS) randomised controlled trial.

   Addiction (Abingdon, England) (Ussher et al.)Published Jul 14, 2026Checked Oct 3, 2026

   “Statistical significance was set at P FindingsAmong the full trial sample, 63% (289/462) of participants had self-reported smoking status at 3-4 years postpartum; 19% (88/462) reported as abstinent, of whom 64% (56/88) underwent biochemical validation with none misclassified. Primary outcome abstinence was 16.4% (26/159) for 12-months incentives, 12.3% (19/154) for 3-months incentives and 7.4% (11/149) for UC. Adjusted odds ratios (OR) (95% confidence interval) for 12-months vs. UC: OR 2.51 (1.18-5.31), P = 0.016, and for 3-months vs. UC: 1.81 (0.83-3.98), P = 0.138. In a fully adjusted model, the difference between 12-month incentives and UC was no longer statistically significant: OR 2.44 (1.11-5.36), P = 0.027, using the Bonferroni correction (P ConclusionsUp to £300 of voucher incentives offered over 12 months postpartum may be effective for maintaining smoking abstinence at 3-4 years postpartum compared with usual care. Up to £120 of incentives over 3 months postpartum does not appear to be beneficial compared with usual care.”

3. 3

   Contingency Management for Smoking Cessation Among Adults Experiencing Homelessness: A Pilot Randomized Clinical Trial.

   JAMA network open (Gu et al.)Published Aug 3, 2026Checked Oct 4, 2026

   “Control participants received $5 per visit regardless of abstinence.Main outcomes and measuresThe preliminary efficacy outcome was 7-day point prevalence abstinence (PPA; CO-verified self-report of abstinence). The secondary outcome was repeated 7-day PPA.ResultsOf 83 participants, 42 were randomized to CM and 41 to a control. The mean (SD) age was 47.0 (10.8) years, and 53 participants (63.9%) were men. At 6 months, 7-day PPA was 31.0% in the CM group and 12.2% in the control group. After adjustment for covariates and with missing data treated as smoking, participants in the CM group had higher odds of achieving 7-day PPA at 6 months than those in the control group (adjusted odds ratio, 3.24 [95% CI, 1.03-10.19]; P = .04).Conclusions and relevanceIn this pilot randomized clinical trial of adults experiencing homelessness, an extended CM intervention was feasible to implement and was associated with higher odds of 7-day PPA than the control condition. These findings suggest that extended CM may be a promising strategy for supporting smoking cessation in this population, but larger trials are needed to confirm efficacy.Trial registrationClinicalTrials.gov Identifier: NCT04982952.”

4. 4

   Feasibility and acceptability of strategies aiming to increase smoking cessation rates among people experiencing homelessness: A scoping review.

   Tobacco prevention & cessation (Redonnet et al.)Published Oct 1, 2026Checked Oct 3, 2026

   “Most interventions aimed at increasing participants' motivation to quit smoking. Counseling/MI and CM were the most frequently tested programs, showing limited to moderate results. TMI had limited results with regard to smoking relapse. All tested interventions were deemed acceptable by participants. Patient-centered and harm reduction approaches were particularly appreciated.ConclusionsThis scoping review shows that counseling/MI and CM, which appear to have limited to moderate effectiveness in terms of smoking cessation support among PEH, are well accepted; however, their feasibility is questionable - especially CM. Other forms of smoking cessation support show lower levels of effectiveness. There is a need for further research on effective and acceptable ways of promoting smoking cessation among marginalized groups such as PEH.”

5. 5

   Financial incentives for smoking cessation among (expectant) parents: a systematic review of facilitators and barriers to implementation.

   Tobacco control (van et al.)Published Jul 28, 2026Checked Oct 3, 2026

   “Thematic analysis identified barriers and facilitators. Subgroup analysis explored patterns specific to lower socioeconomic populations.Data synthesisStudies reported on implementation in the USA (n=18), UK (n=10), Australia (n=4), the Netherlands (n=2), New Zealand (n=1), France (n=1) and international contexts (n=1). Barriers included misalignment with participants' context and resources, recruitment and retention challenges, limited reliability of abstinence verification and high resource demands. Facilitators included ensuring acceptability, accessibility, feasibility, funding and integration into health services.ConclusionsWith the cost-effectiveness of financial incentives for smoking cessation among (expectant) parents already well-documented, this first systematic synthesis of the barriers and facilitators to implementing them in daily practice offers valuable guidance for advancing implementation efforts.Prospero registration number2023:CRD42023407648.”

6. 6

   Promoting healthy behaviour with financial incentives: three challenges and solutions for large scale implementation.

   The European journal of health economics : HEPAC : health economics in prevention and care (Lipman et al.)Published Feb 3, 2026Checked Oct 4, 2026

   “Financial incentives are a promising intervention to promote healthier behaviours and potentially reduce health inequalities. Despite robust evidence supporting their effectiveness in encouraging actions such as smoking cessation, increased physical activity, and improved diet, large-scale implementation of financial incentives in Europe remains limited. This perspective identifies three key challenges impeding their broader use: (1) difficulties in reaching the populations most in need, (2) short-lived behavioural effects after removal of the incentives, and (3) uncertainty about sustainable and equitable funding. Drawing on interdisciplinary evidence, we explore potential solutions such as tailored incentive design, strategies to prolong behavioural change (e.g. intermittent reinforcement or dynamic phase-outs), and the development of public or private funding models. We argue that while financial incentives should not replace structural health policy interventions, they can be a powerful complementary tool. A coordinated research agenda is needed to inform scalable and effective implementation.”

7. 7

   A recommendation to include support for perinatal smoking-cessation treatment in the SAMHSA advisory on contingency management.

   Preventive medicine (Higgins)Published Apr 16, 2026Checked Oct 4, 2026

   “This Commentary offers a brief, evidence-based recommendation that perinatal smoking cessation be included among the list of substance use disorders that the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) has approved for use of federal funds to support Contingency Management (CM) treatment. Perinatal smoking is a serious U.S. public health problem that adversely impacts the health of mothers and exposed infants, and for which more effective and accessible treatments are sorely needed. CM treatment wherein patients receive material incentives contingent on abstaining from drug use or meeting other treatment goals is a highly effective treatment for a broad range of substance use disorders including smoking cessation. Evidence from randomized clinical trials and meta-analyses investigating CM's efficacy for perinatal smoking cessation are briefly summarized. The evidence provides robust empirical support for CM's efficacy for improving perinatal smoking-cessation rates. With SAMHSA's support and broad implementation, CM has the potential to meet the need for more effective and accessible perinatal smoking-cessation treatment in the U.S.”

8. 8

   Smoking cessation (Wikipedia)

   WikipediaPublished Oct 1, 2026Checked Oct 3, 2026

   “Smoking cessation, usually called quitting smoking or stopping smoking, is the process of discontinuing tobacco smoking. Tobacco smoke contains nicotine, which is addictive and can cause dependence. As a result, nicotine withdrawal often makes the process of quitting difficult. Smoking is the leading cause of preventable death and a global public health concern. Tobacco use leads most commonly to diseases affecting the heart and lungs, with smoking being a major risk factor for heart attacks, strokes, chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), emphysema, and various types and subtypes of cancers (particularly lung cancer, cancers of the oropharynx, larynx, and mouth, esophageal and pancreatic cancer). Smoking cessation significantly reduces the risk of dying from smoking-related diseases. The risk of heart attack in a smoker decreases by 50% after one year of cessation. Similarly, the risk of lung cancer decreases by 50% in 10 years of cessation. From 2001 to 2010, about 70% of smokers in the United States expressed a desire to quit smoking, and 50% reported having attempted to do so in the past year.”