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Paying people to quit smoking works — especially for those who need it most. A large randomized trial found that offering up to $600 in financial incentives to medically underserved adults in lung cancer screening programs more than doubled sustained quit rates compared to standard care. Adding free medications alone, however, didn't move the needle.
Quitting smoking is hard, but a financial nudge can make a real difference. A new study published in JAMA found that offering up to $600 in cash incentives — tied to biochemically confirmed abstinence — more than doubled sustained quit rates at 6 months among medically underserved adults enrolled in lung cancer screening (LCS) programs. The trial spanned five major U.S. health systems and included over 3,200 participants across four escalating intervention strategies.
Standard "ask-advise-refer" care yielded just a 4.3% sustained abstinence rate, and adding free nicotine replacement therapy or prescription medications barely budged that figure (5.1%). But layering on financial incentives pushed the rate to 8.8% — a statistically significant jump. Adding a mobile health tool on top of incentives didn't provide additional benefit.
By the Numbers:
Why it matters: Lung cancer screening saves lives, but quitting smoking amplifies that benefit dramatically. This trial shows that financial incentives — not just access to medications — are the key lever for driving meaningful cessation in high-risk, underserved populations.
