The Case for Incentivized Telehealth for Smoking Cessation

Thirty percent of those enrolled in a mobile smoking cessation program remained smoke-free after three months compared to 16% of those who attended standard in-person sessions.

graph depicting proportion of U.S. military veteran participants with biochemically verified prolonged smoking abstinence (with lapses) by treatment group (standard care vs telehealth intervention)

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Quitting smoking is notoriously challenging. Fewer than 1 in 10 adult smokers manage to quit in 2022 despite their desire to do so. Improving access to health care providers, streaming service delivery, and fostering motivation to engage with quit smoking services can bolster support for people wanting to quit smoking. In recent years, providers increasingly use alternative platforms like video calls to meet with patients who cannot attend in-person quit smoking sessions.

Sarah M. Wilson and colleagues studied whether a mobile contingency management program would better support low income individuals with quitting smoking. Mobile contingency management is a program that involves remote counseling sessions and automated cash incentives delivered directly to participants’ smartphones. Researchers compared the percentage of homeless veterans who quit smoking in a 12-week, incentivized, remote program with that in a standard in-person treatment program.

As shown in the figure above, 30% of veterans in the mobile contingency management program remained smoke-free after three months compared to 16% of those who attended standard in-person sessions.

This study highlights that remote counseling sessions show promise in helping homeless tobacco smokers to quit, particularly those facing multiple stressors. Although this new program was unsuccessful in supporting individuals in remaining smoke-free over 12 months, even short breaks from smoking yield significant health improvements, whether it’s a few weeks, or several months. Individualized treatment for smoking cessation will be an important approach for the decreasing numbers of Americans who continue to smoke cigarettes.

Databyte via Sarah M. Wilson, Dan V. Blalock, Jonathan R. Young, et al. Mobile health contingency management for smoking cessation among veterans experiencing homelessness: A comparative effectiveness trial. Preventive Medicine Reports, 2023.