Decreasing Tobacco Use Among Workers: Incentives & Competitions to Increase Smoking Cessation

Task Force Finding & Rationale Statement

Tobacco use is one of the largest causes of preventable premature death in the United States. Reducing tobacco use in adults and reducing non-smokers exposure to environmental tobacco smoke are essential preventive measures to reduce morbidity and mortality associated with tobacco use. Interventions designed to assist with this effort are important options for health promotion in worksites. In addition to preventing tobacco use initiation and reducing exposure to environmental tobacco smoke, to reduce morbidity and mortality associated with tobacco use, a comprehensive prevention effort should help tobacco users to quit. Approximately 70% of tobacco users want to quit; efforts to quit are frequent, even if frequently unsuccessful. Among other qualities, tobacco use reduction efforts in community settings including worksites should be designed to motivate and assist cessation efforts.

An intervention with incentives and competitions among workers can provide an integrated strategy to increase and improve tobacco use cessation. An effective cessation program enhances an individual’s ability to quit successfully. Cessation support can be effective by one or more of the following means: (1) increasing or improving motivation to quit; (2) increasing or improving action to quit; and (3) increasing or improving maintenance of a quit effort. Incentives or rewards can be provided for participation and/or for success in achieving abstinence from tobacco use. Incentives differed in content including guaranteed financial payments and lottery chances for monetary.

Worksite-based Incentives and Competitions When Implemented Alone to Reduce Tobacco Use: Insufficient Evidence
The Task Force finds insufficient evidence to determine if worksite-based incentives and competitions alone is effective in reducing tobacco use among workers.

Because only one study of least suitable design qualified for this review, evidence is considered insufficient.

Worksite-based Incentives and Competitions When Combined with Additional Interventions to Reduce Tobacco Use among Workers: Recommended
To support an individual’s efforts to quit using tobacco products, in this intervention incentives and competitions are offered in conjunction with additional interventions. These additional interventions may include these components: smoking cessation groups; self-help cessation materials; telephone cessation support; workplace smoke-free policies; and social support networks among others.

The Task Force recommends worksite-based incentives and competitions when combined with additional interventions to support individual cessation efforts, based on strong evidence that they are effective in reducing tobacco use among workers.

The qualifying studies included a variety of intervention combinations. For the subset of studies consisting of multicomponent efforts combining incentives with worksite-based cessation groups and additional educational activities or materials, there is sufficient evidence of effectiveness.

 

Review completed: June 2005