Smoking Cessation: Is Money a Motivator?

It’s not news to UK cardiologist Dr. John Kotter that Kentucky is among the states with the highest smoking rates in the nation. But when he speaks to patients who smoke, he is often surprised at how young they were when they picked up the habit. 

"I met a guy recently who started smoking at 7 years old," Dr. Kotter said. "His parents would send him to the convenience store to buy their cigarettes. When he'd get back, his older brothers would make him smoke one because they thought it was funny." 

Fifty years later, the patient is ready to quit, and Dr. Kotter wants to help. Leading the MERIT: Behavioral Interventions for Smoking Cessation study, he hopes to enroll about 200 smokers. 

MERIT is taking a novel approach to smoking cessation — some patients are paid an incentive of $25 to complete enrollment paperwork and given a reward of $10 per week for every week they test negative on a nicotine swab, up to 12 weeks.

Patients are randomized to either the existing standard of care group or the standard of care plus cessation reinforcement group. Both groups receive behavioral counseling and may sue other smoking cessation tools, as well.  

“We are trying to understand the motivators that help someone quit smoking and the barriers that might stop them from quitting,” Dr. Kotter said. “Sometimes a positive motivator can be more effective than a negative motivator. We know it won’t work for everyone, but if we could get 20 percent of people to stop smoking, that would be amazing. We hope it will contribute to lowering the rate of cardiovascular disease in Kentucky.”  

MERIT funds come from the EXCEL (Executive Clinical Expert Leadership) Research Initiative, a new UK program designed to promote projects that support existing Research Priority Areas and that take a transdisciplinary approach, along with UK HealthCare and the cardiology division.  

Dr. Kotter is working closely with Bill Stoops, PhD, associate director for clinical science; Ken Campbell, PhD, director of translational research; Tim McClintock, PhD, the Louis Boyarsky professor of physiology; Dan Han, PsyD, director of the Neuropsychology Division at UK HealthCare; and team members from Behavioral Health and the College of Nursing.  

For those interested in quitting tobacco or learning more about the study, go to ccts.uky.edu/participate-research/current-studies/merit-behavioral-interventions-smoking-cessation