Financial Incentives Nearly Double Quit Rates Among Underserved People Who Smoke in National Study

DETROIT – Offering financial incentives to people trying to quit smoking nearly doubled cessation rates among medically underserved adults undergoing lung cancer screening, according to a large national clinical trial involving Henry Ford Health.

The randomized trial, recently published in JAMA, enrolled more than 3,200 adults across five U.S. medical centers, including Henry Ford Health, Penn Medicine, Lancaster General Health, Geisinger and Kaiser Permanente Southern California. Participants were primarily from populations that traditionally face barriers to high-quality health care, including individuals with lower incomes, those living in rural communities and Black and Hispanic adults.

Researchers compared four smoking cessation strategies. After six months, 8.8% of participants who received free smoking cessation medications and could earn up to $600 in financial incentives had quit, compared with 4.3% receiving usual care. Smoking abstinence was verified through blood or urine testing.

“These are people who have smoked for many years and may have tried to quit before, so we know how difficult successfully quitting can be,” said Christine Neslund-Dudas, Ph.D., a Henry Ford Health researcher and study investigator. “What’s encouraging about these findings is that they give us another tool to consider, particularly for people who may face additional barriers to quitting.”

The study also points to an opportunity for health systems to connect tobacco treatment with lung cancer screening.

People undergoing lung cancer screening are already at increased risk of developing the disease because of their smoking history. At Henry Ford Health, tobacco treatment is integrated into its centralized lung cancer screening program, connecting people who smoke with cessation support as part of the screening process.

“Lung cancer screening gives us an opportunity not only to find cancer earlier, when we have a better chance of treating it successfully, but also to address one of the most important risk factors for cancer and many other diseases,” said Mike Simoff, M.D., a Henry Ford Health pulmonologist and lung cancer screening expert. “When someone comes to us for screening, we have an opportunity to talk about stopping smoking and give them the support they need to make a change that can affect their health for years to come.”

While smoking is most closely associated with lung cancer and other lung diseases, quitting can reduce the risk of numerous health problems, including other cancers and cardiovascular disease.

Quitting tobacco can be extraordinarily difficult, particularly for people facing financial pressures, stress and other challenges. Henry Ford Health’s Tobacco Treatment Service provides telephone-based counseling using motivational interviewing, an approach that helps people examine their reasons for smoking and quitting and helps participants to develop strategies for changing their behavior. Treatment can also include medications to reduce cravings and withdrawal symptoms. The service is offered at no cost to patients as a community benefit.

“Helping people quit means understanding their routines, stress and what motivates them,” said Amanda Holm, MPH, who supports Henry Ford Health’s tobacco treatment service. “Financial incentives could give people a tangible reward for their progress and help build confidence that they can keep going. The money could also be meaningful for someone with limited financial resources.”

How financial incentives could be incorporated into routine health care remains an open question, including who would ultimately pay for them, how much long-term health care savings could be gained, and how such programs could reach people with limited resources.

For more information about lung cancer screening and eligibility, visit HenryFord.com/LungCancerScreening.

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MEDIA INQUIRIES: mediarelations@hfhs.org