A new study published in the New England Journal of Medicine observes that when given a financial incentive, smokers are more likely to quit for a given period of time. In particular, smokers were three times more likely to quit for six months when given approximately up to $750.
This raises several questions regarding study methodology and psychology. The question that sprung quickly into mind was how the payment structure worked. Were study participants paid after completion? Were they paid in advance? Was the payment in the form of a monthly stipend pending proof of smoking cessation? Each of these structures, of course, would have a vastly different effect on the outcome and provide different inferences about the human condition. Surely, for example, if a person were to be paid upon completion of a study, he or she would be more likely to quit smoking. I know that this is not exactly the point of the study -- rather it is more of an economics question to see generally how large the incentive would have to be for smokers to temporarily cease their bad habit. Yet, I am actually fascinated by the psychology underpinning this issue.
I took a look at the source study in the NEJM (a note to readers: you may be able to only view the abstract of the study, as I have a subscrition to the Journal). As suspected, the study participants were periodically interviewed and paid part of the total reward during each interview if they had successfully stopped smoking (proved with a cotinine test) and the rest upon completion. This suggests that individuals would accept some form of reward (not necessarily financial) to temporarily relinquish a bad habit, but I wonder what would happen if the study were expanded for a significantly lengthier period. Suppose the investigators tracked participants for a decade, two decades, etc and offered a substantially larger reward for completion. What if these participants were paid a monthly stipend rather than a lump sum? Would smokers permanantly give it up?
My guess is not. In general, I think, individuals are willing to accept small probabilities of harm or death for small rewards (i.e. jaywalkers accept a small chance of getting killed by a car in order to save a few seconds of time). Conversely, individuals might be willing to accept small monetary rewards to spare some temporary pleasures (cigarette smoke), but are probably not as likely once the magnitude of the risks and rewards are increased.
1 comment:
The idea that smokers will be likely to revert to their previous behavior once the reward schedule of paying them money stops makes sense. However, during the course of paying an individual every month to stop smoking, natural reinforcers will be developing as well. In addition to receiving external money to stop smoking, smokers will be saving the money they would normally be spending to fuel their habit. Smokers who stop due to external financial reward will also likely regain strength in their senses of taste and smell and get some modicum of approval for quitting from others around them. It's just a matter of whether these natural rewards are strong enough to motivate an individual to stop smoking once the external financial incentive is gone. I think they might be sufficient for many people.
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