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Paying people to quit their bad health habits may be a powerful way to address public health issues like smoking, according to a new study in the BMJ. In the study, pregnant women were more than twice as likely to quit smoking when offered financial incentives than when they were given regular counseling.
“If financial incentives are effective and cost effective they may well have the future potential to sit with vaccines as an important preventive healthcare intervention strategy,” the study says.
The research, which looked at more than 600 pregnant women in the United Kingdom, offered women up to $1,200 dollars in shopping vouchers for following steps to quit smoking. Nearly a quarter of women who were offered the money successfully quit smoking. In the control group, a separate group of women received free nicotine therapy and were counseled on how to quit. Less than 9% of those women were able to kick the habit.
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That success gap remained when researchers followed up a year with the women in both groups who had quit. Fifteen percent of the women who had been paid to quit had stayed away from cigarettes, while only 4% of the counseling group quitters had done the same.
Using financial incentives to encourage better health behavior has been explored in depth in recent years by public health experts, but many remain skeptical due to underlying ethical concerns. Some have argued that such incentives are coercive and diminish a person’s sense of personal responsibility. But the researchers in this study argue that it can help in more ways than one; getting additional funds before a child’s birth helps the people who need financial assistance the most at the time they need help.
“In the developed world there is now a clear socioeconomic gradient in smoking, with tobacco use concentrated among the poorest in society,” the study says. “Receipt of financial incentives can contribute to needed household income in advance of the arrival of a baby in low income households.”
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Write to Justin Worland at justin.worland@time.com