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Smoking Cessation Programs Are Less Effective in Smokers with Low Socioeconomic Status Even When Financial Incentives for Quitting Smoking Are Offered—A Community-Randomized Smoking Cessation Trial in Denmark

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  • Charlotta Pisinger

    (Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, 2000 Frederiksberg, Denmark
    Department of Public Health, Faculty of Health Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
    Danish Heart Foundation, 1120 Copenhagen, Denmark)

  • Cecilie Goltermann Toxværd

    (Department of Public Health, Faculty of Health Sciences, University of Copenhagen, 2200 Copenhagen, Denmark)

  • Mette Rasmussen

    (Clinical Health Promotion Centre, WHO-CC, The Parker Institute, Bispebjerg & Frederiksberg Hospital, 2000 Frederiksberg, Denmark
    Clinical Health Promotion Centre, WHO-CC, Department of Health Sciences, Lund University, 223 62 Lund, Sweden)

Abstract

Financial incentives offered to those who quit smoking have been found effective, also in persons with low socioeconomic status (SES), but no previous study has investigated who benefits most: smokers with low or high SES. In this community-randomized trial (“Richer without smoking”), three Danish municipalities were randomized to reward persons who were abstinent when attending the municipal smoking cessation program (FIMs) and three municipalities were randomized to spend the same amount on smoking cessation campaigns recruiting smokers to the smoking cessation program (CAMs). The municipalities each received approximately USD 16,000. An intention-to-treat approach was used in analyses. In regression analyses adjusted for individual- and municipal-level differences, we found that smokers with high SES living in FIMs had significantly higher proportion of validated long-term successful quitters (OR (95% CI): 2.59 (1.6–4.2)) than high-SES smokers living in CAM. Smokers with low SES, however, did not experience the same benefit of financial incentives as smokers with high SES. Neither the FIMs nor the CAMs succeeded in attracting more smokers with low SES during the intervention year 2018 than the year before. Our study showed that smokers with low SES did not experience the same benefit of financial incentives as smokers with high SES.

Suggested Citation

  • Charlotta Pisinger & Cecilie Goltermann Toxværd & Mette Rasmussen, 2022. "Smoking Cessation Programs Are Less Effective in Smokers with Low Socioeconomic Status Even When Financial Incentives for Quitting Smoking Are Offered—A Community-Randomized Smoking Cessation Trial in," IJERPH, MDPI, vol. 19(17), pages 1-15, August.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:17:p:10879-:d:903323
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    References listed on IDEAS

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    1. Ryan J. Courtney & Sundresan Naicker & Anthony Shakeshaft & Philip Clare & Kristy A. Martire & Richard P. Mattick, 2015. "Smoking Cessation among Low-Socioeconomic Status and Disadvantaged Population Groups: A Systematic Review of Research Output," IJERPH, MDPI, vol. 12(6), pages 1-20, June.
    2. Marek Milcarz & Kinga Polanska & Leokadia Bak-Romaniszyn & Dorota Kaleta, 2018. "Tobacco Health Risk Awareness among Socially Disadvantaged People—A Crucial Tool for Smoking Cessation," IJERPH, MDPI, vol. 15(10), pages 1-12, October.
    3. Kendzor, D.E. & Businelle, M.S. & Poonawalla, I.B. & Cuate, E.L. & Kesh, A. & Rios, D.M. & Ma, P. & Balis, D.S., 2015. "Financial incentives for abstinence among socioeconomically disadvantaged individuals in smoking cessation treatment," American Journal of Public Health, American Public Health Association, vol. 105(6), pages 1198-1205.
    4. McCabe, C & Claxton, K & Culyer, AJ, 2008. "The NICE Cost-Effectiveness Threshold: What it is and What that Means," MPRA Paper 26466, University Library of Munich, Germany.
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