Cash Rewards Boost Smoking Cessation in Trial

A Penn Medicine trial found that offering up to $600 in cash rewards nearly doubled quit rates among heavy smokers.

Updated on Nov. 2, 2026 in Asthma

Cash Rewards Boost Smoking Cessation in Trial

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Should health insurers or governments pay smokers cash to help them quit?

Penn Medicine researchers tested a cash incentive of up to $600 for heavy, long-time smokers who received free quitline referrals and nicotine replacement therapy. About nine in 100 participants who received cash rewards quit smoking, compared with about five in 100 without them.

Why it matters

The study adds evidence that immediate financial incentives may help smokers push through withdrawal, irritability, and hunger that long-term health benefits alone do not overcome. Researchers hope more health systems, insurers, and employers will adopt cash incentives for tobacco cessation.

The trial compared about 9 in 100 quitters in the cash incentive group with about 5 in 100 in the group without cash, with rewards paid only after six months of abstinence verified by urine or blood tests. Whether these quit rates persisted beyond six months has not been reported.

The players

Penn Medicine

Penn Medicine is the academic medical system of the University of Pennsylvania, based in Philadelphia, that conducted the trial.

The details

Participants were long-time heavy smokers, including people with low incomes, who were referred for lung cancer screening. One group received free quitline referrals and nicotine replacement therapy, while a second group received the same support plus up to $600 in cash rewards for verified abstinence without relapse.

November 2026: Trial results were published in JAMA.
Six months: Abstinence period required to earn the cash reward.

Big Picture

The trial extends the use of cash incentives already tried for colonoscopies and annual checkups into tobacco cessation. It tests whether the same approach can help heavy smokers overcome withdrawal that outweighs distant long-term health benefits.

Smokers seeking to quit may find that financial incentives help them through the early withdrawal period when cravings are strongest. The trial's results suggest that combining cash rewards with free quitline support and nicotine replacement therapy could improve the chances of quitting.

The takeaway

Immediate financial rewards may be a useful tool for smokers who struggle with withdrawal, since the benefits of quitting often feel distant. Those trying to quit can ask their healthcare providers about available support programs, including quitlines and nicotine replacement therapy.