Commitment Contracts and Team Incentives for Smoking Cessation: A Randomized Controlled Trial in Rural Thailand

Justin S. White, University of California, Berkeley
Suthat Rungruanghiranya, Srinakharinwirot University
Tawima Sirirassamee, Srinakharinwirot University

Tobacco use is a leading cause of death and chronic disease in Southeast Asia, yet smoking cessation programs are not widely available in the region. This study evaluates a novel behavioral intervention that aims to help smokers in rural communities to quit. Thailand is used as a test case. All participants received cessation counseling. In addition, the treatment group (1) made weekly financially deposits to be returned only if each person quit after 3 months, and (2) were assigned to a two-person team, with a cash bonus if both quit after 3 months. The randomized controlled trial recruited 215 smokers from 30 villages, about 10% of all smokers in the study area. Overall, 44% of the treatment group quit, compared to 19% of the control group. The effect size, larger than most previous behavioral interventions, highlights the potential of a combination of financial and social incentives to modify health behavior.