In this project, 1500 patients are randomized to receive rewards for using services to help themselves quit smoking or to a control group. Those receiving rewards have two months to accrue rewards for attending smoking cessation counseling sessions and by engaging in quit activities on stickK.com (journal entries, self-reported smoking status, and signing up supporters) and to quit smoking. Two, six, and twelve months after enrollment, all patients (intervention and control) complete biochemical tests to determine smoking status. A proportion of those receiving rewards and passing their 2-month biochemical test are offered commitment contracts in which they select a percentage of the money they earn during the rewards phase to commit to being smoke free at 6-months. They only receive this invested money if their biochemical verification test comes back negative for smoking.
Smoking remains an incredible public health problem with nearly half a million people in the United States dying prematurely each year due to smoking-related causes. Smoking results in $96 billion in lost productivity, a cost borne disproportionately by low-income and uneducated persons which thereby results in an exacerbation of existing health disparities. Smokers attempting to quit on their own have success rates as low at 2-5%. Thus, this study seeks to determine if the use of commitment contracts can help to improve smoking cessation rates in both the short and long term as compared to only receiving rewards or to receiving no rewards.