BE Smokefree: Behavioral Economics Incentives to Engage Adolescents in Smoking Cessation
Cigarette smoking remains a leading preventable cause of death in the US with substantial morbidity, mortality, and financial costs each year. More than 90% of adult smokers initiate tobacco use before age 18, making prevention and treatment of adolescent smoking a critical health priority. Pediatricians are uniquely positioned to screen for tobacco use, initiate treatment, and connect adolescents to effective smoking cessation services. A critical knowledge gap is how to best to translate screening into effective service receipt and quitting. Behavioral economic interventions utilizing financial incentives can promote smoking cessation in adult populations, and loss-framed incentives may be more effective than reward-based approaches. No studies have evaluated loss-framed financial incentives among adolescents to promote engagement in effective smoking cessation programs.
We propose to leverage existing adolescent tobacco screening activities in the primary care network at The Children’s Hospital of Philadelphia (CHOP) and an existing partnership with the National Cancer Institute (NCI) Smokefree Teen Initiative to accomplish the following aims: 1) To compare, through a pilot, randomized controlled trial, a reward-based, loss-framed or no financial incentive intervention on adolescent smoker enrollment and depth of engagement in a smoking cessation program (smokefreeTXT); and 2) To compare cotinine-confirmed 4-week quit rates across the 3 groups, among users who report abstinence. The study team has administrative and operational support for this effort. Funding provided though ITMAT will act as a critical catalyst for the completion of this work, with the potential for preliminary data to lead to an eventual R01 submission.