美国加州大学Justin S White团队研究了在泰国工作场所的戒烟激励计划。2020年10月14日，该研究发表在《英国医学杂志》上。

为了比较在中等收入国家，几种货币激励计划对工作场所吸烟员工的戒烟效果，研究组在泰国首都曼谷的大型工业场所进行了一项平行组、开放标签、评估者盲、整群随机对照试验。

研究组在101个工作场所集群（84个不同的公司）中招募吸烟并计划在六个月内戒烟的员工，将其随机分组，分别接受常规护理或常规护理联合8种激励计划中的一种。常规护理包括一次性团体咨询和28天短信的戒烟支持计划。激励计划取决于三个月内的戒烟情况，以及三个干预部分：可退还的押金、分配给队友以及奖金数额。主要结局为12个月时生物化学证实的7天点戒烟率。

2015年4月至2016年8月，该试验共招募了4190名参与者，共有4172名被纳入意向性治疗分析。所有组的计划接受度均相对较高：总护理组为58.7％，常规护理组为61.3％。12个月时的戒烟率在押金计划（336/2253，14.9%）和非押金计划（280/1919，14.6%）间没有差异，但团队计划（176/1348，13.1%）略低于个人计划（440/2824，15.6%），40美元奖金计划（322/1954，16.5%）显著高于无奖金计划（148/1198，12.4%）。在所有终点里，40美元的个人奖金计划戒烟效果最有效。干预组之间没有强烈的相互作用。

研究结果表明，金钱激励计划有助于人们长期戒烟。

附：英文原文

Title: Incentive programmes for smoking cessation: cluster randomized trial in workplaces in Thailand

Author: Justin S White, Christopher Lowenstein, Nucharee Srivirojana, Aree Jampaklay, William H Dow

Issue&Volume: 2020/10/14

Abstract:

Objective To compare several monetary incentive programmes for promoting smoking abstinence among employees who smoke at workplaces in a middle income country.

Design Parallel group, open label, assessor blinded, cluster randomized controlled trial.

Setting Large industrial workplaces in metropolitan Bangkok, Thailand.

Participants Employees who smoked cigarettes and planned to quit within six months recruited from 101 worksite clusters (84 different companies).

Interventions Worksites were digitally cluster randomized by an independent investigator to usual care or usual care plus one of eight types of incentive programmes. Usual care consisted of one time group counseling and cessation support through a 28 day text messaging programme. The incentive programmes depended on abstinence at three months and varied on three intervention components: refundable deposits, assignment to a teammate, and bonus size ($20 (￡15; €17) or $40).

Main outcome measures The primary outcome was biochemically verified seven day point prevalence smoking abstinence at 12 months. Secondary outcomes were programme acceptance at enrollment and smoking abstinence at three months (end of intervention) and at six months. All randomized participants who had complete baseline information were included in intention-to-treat analyses; participants with missing outcomes were coded as continuing smokers.

Results Between April 2015 and August 2016, the trial enrolled 4190 participants. Eighteen were omitted because of missing baseline covariates and death before the primary endpoint, therefore 4172 participants were included in the intention-to-treat analyses. Programme acceptance was relatively high across all groups: 58.7% (2451/4172) overall and 61.3% (271/442) in the usual care group. Abstinence rates at 12 months did not differ among deposit programmes (336/2253, 14.9%) and non-deposit programmes (280/1919, 14.6%; adjusted difference 0.8 points, 95% confidence interval 2.7 to 4.3, P=0.65), but were somewhat lower for team based programmes (176/1348, 13.1%) than individual based programmes (440/2824, 15.6%; 3.2 points, 6.6 to 0.2, P=0.07), and higher for $40 bonus programmes (322/1954, 16.5%) than programmes with no bonus (148/1198, 12.4%; 5.9 points, 2.1 to 9.7, P=0.002). The $40 individual bonus was the most efficacious randomization group at all endpoints. Intervention components did not strongly interact with each other.

Conclusions Acceptance of monetary incentive programmes for promoting smoking abstinence was high across all groups. The $40 individual bonus programmes increased long term smoking abstinence compared with usual care, although several other incentive designs did not, such as team based programmes and deposit programmes. Incentive design in workplace wellness programmes might influence their effectiveness at reducing smoking rates in low resource settings.

DOI: 10.1136/bmj.m3797

Source: https://www.bmj.com/content/371/bmj.m3797