Why are Financial Incentives not Effective at Influencing Some Smokers to Quit? Results of a Process Evaluation of a Worksite Trial Assessing the Efficacy of Financial Incentives for Smoking Cessation

Objective: Process evaluation of a worksite intervention in which employees were offered $750 to complete a cessation program and to quit smoking. Methods: Awareness and attitudes about financial incentives were assessed following a randomized controlled trial of 878 smokers at a US-based company. Results: Cessation program attendance was higher in incentive group versus control (20.2% vs 7.1%, P < 0.01). Most quitters (69.8%) in the incentive group who were already motivated to quit and reported that they would have quit for less money, said incentives were not at all or only somewhat important. Most nonquitters in the incentive group reported that even $1500 would not have motivated them to quit. Conclusions: Financial incentives are ineffective at motivating some smokers to quit. Internal motivation and readiness to quit need to be sufficiently high for relatively modest incentives to be effective.