Clinical Scorecard: Can Financial Incentives Help Smokers Quit?

At a Glance

Key Highlights

• Participants were followed for six months, and abstinence was verified by blood testing.

• Reported quit rates were 3% with usual care, 1% with usual care plus free medications, 8% with usual care, free medications, and incentives, and 2% when FutureMe was added to that approach.

• The authors reported significantly higher quit rates among participants offered financial incentives.

• The investigation included medically underserved groups and people referred for pulmonary malignancy screening.

Guideline-Based Recommendations

Diagnosis

• Identify current smokers referred for low-dose CT lung cancer screening and assess their smoking status and interest in quitting.

Management

• Provide usual ask-advise-refer care and consider offering free smoking-cessation medications.

• Financial incentives of up to $600 were associated with higher quit rates when added to usual care and free medications.

• Adding the FutureMe text-based tool did not produce a higher reported quit rate in this study.

Monitoring & Follow-up

• Follow participants over six months and assess smoking abstinence.

• Verify abstinence with blood testing, as in the study.

Risks

• The study evaluated smoking-cessation approaches; the source material does not report specific treatment-related risks or adverse effects.

Patient & Prescribing Data

More than 3,200 current smokers referred for low-dose CT lung cancer screening; the cohort included Black or Hispanic participants, people with limited incomes, and rural residents.

Quit rates were 3% with usual care, 1% with usual care plus free medications, 8% with usual care, free medications, and financial incentives, and 2% when FutureMe was added. Participants were offered financial incentives of up to $600.

Clinical Best Practices

• Use lung cancer screening referrals as an opportunity to identify current smokers and offer smoking-cessation support.

• Provide usual ask-advise-refer care and consider free cessation medications; the study found the highest reported quit rate when financial incentives were added to this approach.

• Consider financial incentives as an adjunct to cessation care, recognizing that the study offered incentives of up to $600 and followed participants for six months.

• Do not assume that adding the FutureMe text-based tool improves quit rates; it did not increase the reported rate in this study.

• Assess abstinence at follow-up and, when appropriate, verify it with blood testing as done in the study.

Related Resources & Content

1. JAMA, 2026 -- Smoking Cessation Among Underserved Patients Referred for Lung Cancer Screening: A Randomized Clinical Trial

2. United States Preventive Services Taskforce, 2021 -- Tobacco Smoking Cessation in Adults, Including Pregnant Persons: Interventions

3. World Health Organization, 2024 -- WHO clinical treatment guideline for tobacco cessation in adults

4. NICE -- Treating tobacco dependence during pregnancy and in the first year after childbirth

5. Cochrane, 2025 -- Can rewards help people quit smoking, and do they work in the long term?

6. Stat News — Quitting smoking is hard. A Medicare change may push doctors to give more help

7. ADA News — ADA supports tobacco cessation bill

8. The ASCO Post — Media Campaign with Real Smokers a Success

9. ada news — ADA supports tobacco cessation bill

10. Smoking Cessation Among Underserved Patients Referred for Lung Cancer Screening: A Randomized Clinical Trial

11. Tobacco Smoking Cessation in Adults, Including Pregnant Persons: Interventions

12. WHO clinical treatment guideline for tobacco cessation in adults

13. Treating tobacco dependence during pregnancy and in the first year after childbirth

14. Can rewards help people quit smoking, and do they work in the long term?

15. WHO clinical treatment guideline for tobacco cessation in adults

16. Can rewards help people quit smoking, and do they work in the long term? | Cochrane