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Tobacco Use and Secondhand Smoke Exposure: Incentives and Competitions to Increase Smoking Cessation Among Workers – When Used Alone


What the Task Force Found

About The Systematic Review

The Task Force finding is based on evidence from a systematic review of 1 study (search period January 1980–March 2005). The review was conducted on behalf of the Task Force by a team of specialists in systematic review methods, and in research, practice, and policy related to reducing tobacco use and secondhand smoke exposure.


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Summary of Results

One study was included in the review.

  • Over a 12-month intervention period, 32.8% of the baseline participants continuously abstained from using tobacco.  
  • Verified cessation rates were, respectively, 49% and 36% at 6 and 12 months into the contest period.

Summary of Economic Evidence

An economic review of this intervention was not conducted because the Task Force did not have enough information to determine if the intervention works.


Applicability of this intervention across different settings and populations was not assessed because the Task Force did not have enough information to determine if the intervention works.

Evidence Gaps

Each Community Preventive Services Task Force (Task Force) review identifies critical evidence gaps—areas where information is lacking. Evidence gaps can exist whether or not a recommendation is made. In cases when the Task Force finds insufficient evidence to determine whether an intervention strategy works, evidence gaps encourage researchers and program evaluators to conduct more effectiveness studies. When the Task Force recommends an intervention, evidence gaps highlight missing information that would help users determine if the intervention could meet their particular needs. For example, evidence may be needed to determine where the intervention will work, with which populations, how much it will cost to implement, whether it will provide adequate return on investment, or how users should structure or deliver the intervention to ensure effectiveness. Finally, evidence may be missing for outcomes different from those on which the Task Force recommendation is based.

Identified Evidence Gaps

Only a single study of worksite-based incentives or competitions when implemented alone was identified, thus there was an insufficient number of studies to draw a conclusion on the evidence on effectiveness. Consequently, this intervention approach remains a potential area for future research. An earlier Community Guide review of community-based smoking cessation contests also found insufficient evidence to support a conclusion on effectiveness. In the community-based intervention studies, evidence was considered insufficient because most studies focused only on contest participants and did not include either a defined study population of eligible tobacco users or a concurrent comparison group. Worksite-based interventions, in contrast to community-based efforts, provide a study population that may be easier to quantify and define, and should provide an opportunity to evaluate participation and impact among eligible tobacco users. In addition, incentives might be offered in ways other than through tobacco cessation contests (such as rewards for setting and achieving personal health goals) and these intervention options remain an area for further research.

Study Characteristics

  • One study from Sweden evaluated a worksite-based tobacco cessation contest with a precontest promotion, an enrollment period, biochemical verifıcation of self-reported abstinence at each assessment, and three lottery drawings over a 12-month intervention period (at 1, 6, and 12 months).
  • 10% of tobacco-using workers participated in the intervention.