Competition/cooperation in worksite smoking cessation using nicotine gum

doi:10.1016/0091-7435(89)90022-4

Preventive Medicine

Volume 18, Issue 6, November 1989, Pages 867-876

https://doi.org/10.1016/0091-7435(89)90022-4 Get rights and content

Abstract

Worksite competitions have shown promise in facilitating smoking cessation among employees, but the effectiveness of the competition component itself has not been determined. A multicomponent behavioral treatment and maintenance program plus nicotine gum were provided to competition and no-competition conditions at two large worksites. At 1-year follow-up, 100% of subjects were contacted and measurement of expired carbon monoxide validated abstinence. Recruitment rates were significantly higher in the competition group (2% of smokers) than the no-competition group (0.6% of smokers, P < 0.001). One-year abstinence rates were 50% for the competition group and 25% for the no-competition group. This difference was not statistically significant (P < 0.25). However, survival analysis revealed a significant difference in number of weeks abstinent during the year after treatment. Mean weeks abstinent was 35 for competition and 22 for no-competition (P < 0.05). At the 3-month follow-up, the number of boxes of nicotine gum used predicted abstinence (P < 0.002). At the 1-year follow-up, rated supportiveness of one's “buddy” (P < 0.01) and number of sick days prior to starting the program predicted abstinence (P < 0.003). It is suggested that competition, nicotine gum, and social support may enhance worksite smoking cessation program rates.

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Cited by (24)

Worksite-Based Incentives and Competitions to Reduce Tobacco Use. A Systematic Review
2010, American Journal of Preventive Medicine
Citation Excerpt :
Additional interventions used in conjunction with incentives and competitions to promote smoking cessation among participants included smoking cessation groups, self-help cessation materials, telephone cessation support, workplace smoke-free policies, and social support networks. The team identified a total of 26 studies22–47 evaluating worksite-based incentives and competitions when combined with additional interventions to reduce tobacco use among workers. Nine studies with limited quality of execution22,24,32,35,38,40,42–44 and three studies with least suitable study designs27,28,33 were excluded from the final body of evidence.
The Guide to Community Preventive Service (Community Guide) methods for systematic reviews were used to evaluate the evidence of effectiveness of worksite-based incentives and competitions to reduce tobacco use among workers. These interventions offer a reward to individuals or to teams of individuals on the basis of participation or success in a specified smoking behavior change (such as abstaining from tobacco use for a period of time). The review team identified a total of 26 published studies, 14 of which met study design and quality of execution criteria for inclusion in the final assessment. Only one study, which did not qualify for review, evaluated the use of incentives when implemented alone. All of the 14 qualifying studies evaluated incentives and competitions when implemented in combination with a variety of additional interventions, such as client education, smoking cessation groups, and telephone cessation support. Of the qualifying studies, 13 evaluated differences in tobacco-use cessation among intervention participants, with a median follow-up period of 12 months. The median change in self-reported tobacco-use cessation was an increase of 4.4 percentage points (a median relative percentage improvement of 67%). The present evidence is insufficient to determine the effectiveness of incentives or competitions, when implemented alone, to reduce tobacco use. However, the qualifying studies provide strong evidence, according to Community Guide rules, that worksite-based incentives and competitions in combination with additional interventions are effective in increasing the number of workers who quit using tobacco. In addition, these multicomponent interventions have the potential to generate positive economic returns over investment when the averted costs of tobacco-associated illnesses are considered. A concurrent systematic review identified four studies with economic evidence. Two of these studies provided evidence of net cost savings to employers when program costs are adjusted for averted healthcare expenses and productivity losses, based on referenced secondary estimates.
Effectiveness of monetary incentives for recruiting adolescents to an intervention trial to reduce smoking
2000, Preventive Medicine
Background. The study objective is to evaluate the effect of monetary incentives on response rates of adolescents to a smoking-related survey as the first step toward participation in an intervention trial.
Methods. A sample of 4,200 adolescent members of a managed care organization were randomized to one of four incentive groups: a $2 cash group, a $15 cash group, a $200 prize drawing group, or a no-incentive group. We compared group-specific response rates and willingness to be contacted about future study activities, as well as costs.
Results. Incentives increased survey response rates (55% response without incentive vs a 69% response with incentive), with response of 74% in the $15 cash group, 69% in the token group, and 63% with a prize incentive. Incentives did not adversely affect willingness of adolescents to be contacted about a smoking intervention, (65% willing with incentives vs 60% without, P = 0.03). In terms of cost per additional survey completed, token and prize groups were marginally more expensive than the no-incentive group ($0.40 and $1.42, respectively) while the large cash incentive was substantially more costly ($11.37).
Conclusions. Monetary incentives improve response rates to a mailed survey, without adverse impact on willingness to further participate in intervention activities. However, a variety of issues must be considered when using incentives for recruitment to intervention studies.
Results of a year-long incentives-based worksite smoking-cessation program
1993, Addictive Behaviors
This study evaluated the impact of a year-long incentives-based worksite smoking-cessation program. Nineteen moderate-sized worksites, employing a total of approximately 1100 smokers, were randomized to Incentive or No Incentive conditions. All identified smokers in the worksite were considered as subjects, whether or not they participated in the intervention. Analyses were conducted at both the worksite and individual level, and using both self-reported and biochemically validated cessation as endpoints. The incentive program did not significantly improve cessation rates at either the 1-year or 2-year follow-up assessments. We conclude that more broadly focused interventions that also address worksite smoking policies, skills training, and cessation resources, or programs that target additional risk factors are needed to substantially enhance quit rates.
Competitions for smoking cessation
2019, Cochrane Database of Systematic Reviews
Incentives for smoking cessation
2015, Cochrane Database of Systematic Reviews
The WERO group stop smoking competition: Main outcomes of a pre- and post- study
2014, BMC Public Health

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^☆: This research was funded by and Nicorette gum was supplied by Merrell Dow Pharmaceuticals, Cincinnati, OH.

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Competition/cooperation in worksite smoking cessation using nicotine gum☆

Abstract

Prog Behav Modif

Prev Med

Addict Behav

Behav Ther

Prev Med

Health promotion in the workplace

Am Psychol

A worksite smoking modification competition: Potential for public health impact

Am J Public Health

An employee incentive program to reduce cigarette smoking

J Consult Clin Psychol

Worksite smoking cessation programs: A potential for national impact

Am J Public Health

Smoke Holding: An Evaluation of Physiological Effects and Treatment Efficacy of a New Non-hazardous Aversive Smoking Procedure