Smokers who are offered cash incentives are far more likely to give up cigarettes than those who are simply offered tips on how to quit, said a US study on Monday.
The approach could offer ways to cut the number of smokers, which has remained steady at about one-fifth of the US population in recent years, according to the report in the Journal of the American Medical Association (JAMA) Internal Medicine.
The rate among the poor is even higher. A total of 26% of smokers in the US in 2015 were below the poverty line, compared to 14% of smokers at or above the poverty line, according to background information in the article.
The randomised clinical trial included 352 people in Boston, Massachusetts.
Participants were recruited from hospital waiting rooms. Those entering the study all smoked more than 10 cigarettes per day and wanted to quit. Most were African-American women.
Some were given a brochure and a list of community resources available to help people quit smoking.
Others received the same resource list, along with extra counseling sessions on how to quit from "patient navigators," and were also told they would get a cash payment if they managed to give up cigarettes.
Participants were not told how much they would get paid for quitting when they entered the year-long study.
Halfway through, those who quit were paid $250, and told they would get an additional $500 if they were not smoking at 12 months.
Nearly 10% of the incentive group had quit by six months, compared to less than 1% of those offered a brochure.
Those who had not quit by six months were given a chance to keep trying in exchange for a payment.
"After 12 months, 12% of the intervention group quit smoking, while 2% of the control group had quit," said the study.
Urine and saliva tests confirmed whether smokers had indeed quit or not.
Lead author Karen Lasser, associate professor of medicine at Boston University School of Medicine, said the study shows a multi-faceted approach that employs incentives works best.
"Most of the participants who quit smoking utilised patient navigation, but it's unclear whether navigation alone would achieve the rates of smoking cessation we observed," she said.