For Smoking Cessation, Money Whispers Louder than Nicotine Replacement

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While that may be a major factor in smoking-related health impacts, a new study in the Journal of Physiology now posits a new theory: that smoking actually deceases the number of blood vessels in the legs, therefore directly damaging muscles. "Programs that offered financial incentives tripled the rates of smoking cessation, reduced employers' costs per successful quit as compared with programs that offered cessation aids alone, and yielded total costs that compared favorably with the costs of employing smokers", they write.

The new study differed from usual studies of smokers wanting to quit: It automatically enrolled smokers in 54 company wellness programs and asked those who didn't want to join to opt out. Only 125 did, but the vast majority of the rest didn't actively participate yet their results were tracked as part of the study.

The success rates of each of the strategies among engaged participants, ranked from highest to lowest, are as follows: redeemable deposit (12.7 percent); reward (9.5 percent); e-cigarettes (4.8 percent); free cessation aids (2.9 percent); usual care (0.7 percent).

Note that this multi-arm randomized trial found that financial incentives increased the rate of smoking abstinence compared with usual care or nicotine replacement therapy.

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Scott Halpern, the lead author of the NEJM study and a professor of medicine at the Perelman School of Medicine at the University of Pennsylvania, says the study provides some of the most robust data ever compiled on the ineffectiveness of e-cigarettes. The Food and Drug Administration is mulling how to regulate them, and earlier this year, a national panel of experts said vaping may help folks reduce smoking but that more research is needed.

Almost 1,200 participants really got into it. Of course, both of these groups received some free items to help them quit. The groups offered cash did best; rates among the other groups did not differ much from each other. By contrast, no differences were found in the quit rates among participants assigned to free e-cigarettes, free cessation aids, or usual care. It turns out nothing can get smokers to quit like paying them to do it. In fact, as other studies have shown, they may be doing more harm than good by introducing teens who have never smoked to cigarettes. Those active participants showing real interest during the trial were reported to be more inspired of quitting smoking. But in a more recent time period, 2010 to 2014, women had an 8 percent higher incidence rate than men, said one study leader, the American Cancer Society's Ahmedin Jemal. "But we have to be careful not to make more of the results than is there", Abrams said.

It's a big question for smokers and policymakers alike: Do electronic cigarettes help people quit?

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