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Payers can curb smoking-related costs by making members pay

NEJM: Stick better than carrot for effective smoking cessation

Insurers may want to consider penalizing members who don't quit smoking as an incentive to motivate them into changing the expensive behavior that costs insurers billions of dollars in healthcare coverage.

That's because a recent study published in the New England Journal of Medicine found that, while offering incentives was effective at getting people to stop smoking, fining those individuals if they failed to succeed nearly doubled the chances of success.

"Adding a bit of a stick was much better than a pure carrot," Scott Halpern, lead study author and deputy director of the Center for Health Incentives and Behavioral Economics at the University of Pennsylvania School of Medicine, told the New York Times.

The study followed two groups of people trying to quit smoking. In one group, participants had to deposit $150 at the beginning of the program. If they quit smoking within six months, they received the deposit back as well as a $650 reward. Members of the second group had no deposit; they instead received $800 after six months if they stopped smoking.

The second group had a 17 percent success rate, compared to the more than 50 percent success in the penalty group. That means the individuals who paid the deposit were almost twice as likely to stop smoking as those who chose to receive only rewards and support, including free counseling or nicotine replacement therapy.

Since many insurers offer smoking cessation programs, either as part of an overall wellness program or as stand-along benefits, they may want to reconsider how they structure the cessations. "Employers and insurers could do a whole lot more to curb smoking than they currently are," Halpern told NPR Shots. "And doing so, they would reduce costs to themselves and improve public health."

Since the Centers for Disease Control and Prevention estimates that about 9 percent of all healthcare dollars are spent as the result of smoking, as FierceHealthFinance previously reported, there's a lot of money for insurers to save.

To learn more:
- here's the NEJM study
- read The New York Times article
- see the NPR Shots article

Related Articles:
CDC: Smoking accounts for 9% of all healthcare spending
Should insurers treat e-cigarettes like traditional tobacco products?
Lower premium surcharges still prevent smokers from buying coverage