Cash Rewards Nearly Double Heavy Smokers' Quit Rates

Adults who smoked heavily for years quit more often when paid up to $600 for six months of verified abstinence.

Updated on Nov. 2, 2026 in Asthma

A cigarette rests beside folded banknotes on a weathered brick windowsill, with a blurred city street behind. — Penn Medicine researchers found that heavy, long-time smokers paid up to $600 for six months of verified abstinence quit at nearly double the rate of those receiving standard support, a JAMA-published trial found. AI Illustration. Upload story photo >

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

A Penn Medicine trial tested whether a cash incentive helps heavy, long-time smokers quit, and results were published in JAMA in November 2026. Adults who received up to $600 in cash rewards quit at a higher rate than those who received only standard quitting support, which is relevant to smokers and the health systems that serve them.

Why it matters

Quitting smoking remains one of the most effective steps heavy smokers can take to lower their risk of lung cancer and other serious disease, but many struggle to stay quit. The trial suggests that immediate financial rewards may help smokers get through the withdrawal, irritability, and cravings that long-term health benefits often fail to outweigh in the moment.

This was a randomized trial of heavy, long-time smokers referred for lung cancer screening, including many with low incomes. Quit success was about 9 in 100 with cash incentives versus about 5 in 100 without them, with success verified by urine or blood tests at six months.

The players

Penn Medicine

The Penn Medicine health system conducted the trial, which is part of a broader research effort on tobacco treatment and cancer prevention.

JAMA

The Journal of the American Medical Association is a major peer-reviewed medical journal that publishes clinical trial results.

The details

Both trial groups received free quitline referrals and free nicotine replacement therapy. The second group also could earn up to $600 in cash, paid only if they stopped smoking and did not relapse by the six-month mark. Because the payment depended on verified abstinence, the incentive rewarded the quit itself rather than just enrollment in a program.

Trial results were published in JAMA in November 2026.
Cash rewards required abstinence without relapse through six months.

Health Landscape

Cash incentives have already been used in healthcare to encourage preventive behaviors such as annual checkups and colonoscopies. This trial applies the same approach to tobacco treatment, a condition where quit rates after standard support have remained modest.

If you are a longtime smoker, this trial suggests that financial incentives may make quitting easier, so it is worth raising quitting support with your doctor. Ask whether your clinic or insurer offers quitline referrals, nicotine replacement therapy, or other cessation programs.

The takeaway

Cash incentives tied to verified abstinence roughly nearly doubled quit rates in this trial compared with standard support alone. If you smoke, discuss cessation options with your physician, including whether a quitline or program with incentives is available to you.