An Alaska-based study will explore the possible role of financial incentives and family support in the process of quitting smoking. The work is a collaboration between the Mayo Clinic and Alaska tribal health groups.
“The idea is to develop an effective and culturally aligned approach to help Alaska Native people quit smoking,” said Dr. Timothy Thomas, a research physician with the Alaska Native Tribal Health Consortium.
He said this research is adapted from several previous Mayo studies of smoking cessation in Alaska, and with input from tribal leadership. The study is currently in the beta testing stage, but eventually it will include 1,200 pairs of Alaska Native people who smoke, and support people.
For the larger study, the smoker will take frequent breathalyzer and swab tests at home, then receive a financial reward if they’ve successfully abstained from smoking. But, as Thomas explained, it’s a randomized control trial, so not every participant will have the same experience.
“We believe that incentives will work, but in the world of science and research, we have to prove it. And what that usually means in our world of research is randomizing people,” he said. “Some people will receive a reward for the six months, every time they quit, some people will receive an escalating amount.”
There’s also an arm that will receive no financial incentive, as a control.
Thomas said smoking rates are higher in Alaska than other states, and higher still among Alaska Native people, which motivated the ANTHC to fund this research.
“The cost of tobacco to the healthcare setting in Alaska is huge. It’s estimated that for each year, it costs Alaska about $575 million in direct medical costs,” he said. “More Alaskans die from tobacco-related illnesses than they do from suicide, motor vehicle crashes, chronic liver disease, homicide and HIV/AIDS combined.”
Funding also comes from a National Institutes of Health grant.
Thomas said because of past research, he’s very optimistic about the inclusion of financial incentives. But the implementation of a strategy like that in the real world, he said, requires a bigger conversation about the American healthcare system.
“Historically, we’ve spent a lot of our money on the treatment end of the spectrum, and less on the prevention end,” Thomas said. “And so I think that’s a big question, and I think politicians need to weigh in on this, in terms of where we’re gonna put our healthcare dollars.”
The researchers are currently working out the kinks with a 20-person beta test, and plan to begin recruiting for the larger research study next spring. They’ll also host a symposium in Anchorage next March, where they’ll present about Alaska Native youth tobacco use.
