Our primary conclusion is that there is a lack of compelling evidence that incentives of any form represent a compelling NCD reduction strategy .
The rising epidemic of non-communicable diseases ( NCDs ) poses substantial health and economic challenges to both individuals and society .
Application of incentive-based strategies based on traditional and behavioural economic theory has emerged as a potential strategy to address rising rates of NCDs .
Yet , whether or not incentives truly represent a promising strategy for addressing NCDs has not been systematic ally addressed nor is it clear whether certain behavioural economic strategies outperform others or simply offering a cash-based incentive for meeting a goal .
In this systematic review we aim to determine whether there is an evidence base for any of these strategies .
Effects of Large Financial Incentives for Long-Term Smoking Cessation: A Randomized Trial.
BACKGROUND It is not known whether large financial incentives enhance long-term smoking cessation rates outside clinical or workplace setting s. OBJECTIVES The goal of this study was to test whether large financial incentives improved long-term smoking cessation rates in low-income smokers , in a general population setting , without face-to-face or telephone counseling . METHODS This was a 2-arm , parallel group , individually r and omized controlled trial , with follow-up after 3 , 6 , and 18 months . Participants were 805 low-income smokers enrolled between 2011 and 2013 from the general population in Geneva , Switzerl and . We r and omly assigned participants to receive either booklets plus access to a smoking cessation website ( control group , n = 404 ) , or the same intervention plus financial incentives ( intervention group , n = 401 ) . Incremental financial rewards , to a maximum of U.S. $ 1,650 , were offered for biochemically verified abstinence at 1 , 2 , and 3 weeks , and 1 , 3 , and 6 months . No in-person counseling , telephone counseling , or medications were provided . The primary outcome was continuous abstinence between 6 months ( end of incentives ) and 18 months ( 12 months after the incentives ended ) , verified by expired carbon monoxide and salivary cotinine . We also assessed biochemically verified 7-day abstinence at 3 , 6 , and 18 months . RESULTS Rates of continuous abstinence between months 6 and 18 were 9.5 % in the incentive group and 3.7 % in the control group ( p = 0.001 ) . Rates of 7-day abstinence were higher in the incentive group than in the control group at 3 ( 54.9 % vs. 11.9 % ; p < 0.001 ) , 6 ( 44.6 % vs. 11.1 % ; p < 0.001 ) , and 18 months ( 18.2 % vs. 11.4 % ; p = 0.006 ) . CONCLUSIONS In low-income smokers who did not receive face-to-face or telephone smoking cessation counseling , large financial incentives increased long-term rates of smoking cessation .  ( Financial incentives for smoking cessation in low-income smokers ; IS RCT N04019434 )
Our primary conclusion is that there is a lack of compelling evidence that incentives of any form represent a compelling NCD reduction strategy .
The rising epidemic of non-communicable diseases ( NCDs ) poses substantial health and economic challenges to both individuals and society .
Application of incentive-based strategies based on traditional and behavioural economic theory has emerged as a potential strategy to address rising rates of NCDs .
Yet , whether or not incentives truly represent a promising strategy for addressing NCDs has not been systematic ally addressed nor is it clear whether certain behavioural economic strategies outperform others or simply offering a cash-based incentive for meeting a goal .
In this systematic review we aim to determine whether there is an evidence base for any of these strategies .