Way to Quit

Financial incentives to quit smoking work and even more so when own money is staked. Program rolled out across all CVS employees.

Scott Halpern, MD, PhD
Principal Investigator
David Asch, MD, MBA
Principal Investigator
Kevin Volpp, MD, PhD
Principal Investigator

Aim and key question

The impact of reduced smoking is well known. As health insurance premiums continue to grow, reduction in smoking can have a significant impact on the employers bottom line. Additionally, financial incentives have been shown to promote a variety of health behaviors. For example, in a randomized, clinical trial involving 878 General Electric employees, a bundle of incentives worth $750 for smoking cessation nearly tripled quit rates, from 5.0% to 14.7% and led to a program adapted by General Electric for its U.S. employees. This study delved into this deeper to design an incentive model that could be applied across all of CVS.

The key question being researched was what incentive models would deliver the highest smoking cessation rates sustainably.

Intervention and design

This was one of our larger trials and included about 2500 participants.

Interventions - CVS Caremark employees and their relatives and friends were randomly assigned to one of four incentive programs or to usual care for smoking cessation. Two of the incentive programs targeted individuals, and two targeted groups of six participants. One of the individual-oriented programs and one of the group-oriented programs entailed rewards of approximately $800 for smoking cessation; the others entailed refundable deposits of $150 plus $650 in reward payments for successful participants. Usual care included informational resources and free smoking-cessation aids.

Main Outcomes and Measures - The primary outcome that was measured was smoking cessation rates and ongoing reduction post incentives.

Way to Health use

  • Enrollment: Enroll and randomize participants across the study arms

  • Device Integration: Collect data from the devices by patient

  • Rules Engine: Set and monitor activity and achievement vs targets

  • Behavioral Economics: Award cash incentives by study arm

Findings and conclusions

2,538 employees of CVS were randomized to rewards vs opportunity to deposit own money and receive match

  • Of the 90% were willing to enter a reward program, 17.1% of those quit
  • Of the 13.7% were willing to put their own money down, 52.3% of those quit

Publications