Incentives for workplace smoking cessation.

Each year, 19,000 people in the Netherlands die as a consequence of smoking tobacco. Smoking is

also a large economic burden for society and employers. The aim of this study is to evaluate whether

for tobacco smoking employees an incentive (compared to no incentive) will increase the

effectiveness and cost-effectiveness of smoking cessation therapy by increasing the number of

successfully quitted smokers when offered within a company setting in the Netherlands.



In this cluster-randomized trial, employees in the intervention and control group both participate in

smoking cessation group training. This treatment consists of seven weekly group counseling sessions

of 1.5 hours. The intervention group receives a voucher for smoking abstinence immediately after

counseling (€50), after three months (€50), after six months (€50), and after one year (€200). The

control group will not receive incentives. The main study parameter is the effect of the incentive in

the intervention group on the quit rate at twelve months. Quit rate will be determined by seven-day

point prevalence abstinence and prolonged abstinence. Biochemical validation of smoking

abstinence will be done using expired air carbon monoxide (CO). Additionally, a cost-effectiveness

analysis will be performed from the societal and employers’ perspective.

Each year, 19,000 people in the Netherlands die as a consequence of smoking tobacco. Tobacco is also a large economic burden for society and employers. A study conducted in the United States provided evidence that an incentive for smoking abstinence in a company setting can increase smoking cessation rates. This study will demonstrate whether incentives in the form of vouchers for health promoting articles increase the effectiveness and the cost-effectiveness of evidence-based interventions for smoking cessation when offered within a company setting in the Netherlands. The study will also generate recommendations for companies that want to implement smoking cessation support with incentives. The ultimate aim of our intervention is to increase successful smoking cessation among employees in the Netherlands.

The quit rate at all time points for the main and secondary study parameters will be determined by seven-day point prevalence abstinence and prolonged abstinence. Biochemical validation of smoking abstinence will be done using expired air carbon monoxide (CO), with a cut-off point of 9 parts per million.


The time horizon for the CEA and CUA measurement points will be combined with the effectiveness study, i.e. baseline, 3 months, 6 months, and 12 months measurements. Utilities will be derived from the standard quality of life questionnaire, EuroQol 5-D-5-L, using Dutch tariff.

Employees in the intervention and control group both participate in a smoking cessation treatment, which is independent of the proposed study. This treatment consists of seven weekly group counseling sessions of 1,5 hours. The intervention group receives a voucher for smoking abstinence immediately after counseling (€50), after three months (€50), after six months (€50), and after one year (€200). The control group will not receive incentives.