JMIR Publications

ABSTRACT

Background:

Tobacco treatment interventions that begin during hospitalization and continue for 1 month are effective in promoting smoking cessation. However, there is low utilization of post-discharge tobacco treatment services.

Objective:

We sought to determine the feasibility and acceptability of a post-discharge financial incentive intervention to promote smoking cessation in individuals who smoke cigarettes.

Methods:

We collaborated with Vincere Health, Inc. to tailor their mobile application that uses facial recognition features, a breath test carbon monoxide (CO) monitor, and smartphone technology to deliver financial incentives to a participant’s digital wallet after completion of each CO test. The program includes 3 tracks. Track 1: Non-contingent incentives for conducting CO tests. Track 2: Combination of non-contingent and contingent incentives for CO levels <10 ppm. Track 3: Contingent incentives only for CO levels <10 ppm. We pilot-tested the program from September-November 2020 with a convenience sample of 33 hospitalized individuals. Participants received text reminders to conduct CO tests twice daily for 30 days post-discharge. We collected data on engagement, CO levels, and incentives earned. We measured feasibility and acceptability quantitatively and qualitatively at 2- and 4- weeks.

Results:

Seventy-six percent (25/33) completed the program and 61% (20/33) conducted at least one breath test each week. Participants reported high program satisfaction and that the intervention helped motivate smoking cessation.

Conclusions:

Financial incentives paired to measurements of exhaled CO concentration levels through a mobile app is a feasible and acceptable intervention to promote smoking abstinence achieved in the hospital in the post-discharge period. Further study is warranted.