In an ideal world, the reward of good health would be enough to motivate prudent behavior, but it often falls short. Smoking rates in America have come down, but progress is slowing, and despite lots of attention to the problem, obesity rates continue to grow. The May 2011 issue of the Harvard Men’s Health Watch asks the question “Can financial incentives help change unhealthy behavior when common sense and medical advice have failed?” Two recent studies suggest the answer is a qualified yes.

To find out if financial incentives can boost smoking cessation rates, researchers studied 878 employees of a large multinational corporation based in the United States. All were active cigarette smokers who had expressed the desire to quit. Half the volunteers were randomly assigned to receive information about smoking cessation programs. The others received the same information plus a series of financial incentives. To make sure money didn’t induce fibbing, the scientists verified tobacco abstinence by using a urine test for cotinine, a chemical produced when the body metabolizes nicotine.

The results show that paying can pay off. Members of the incentive group were more likely to enroll in a smoking cessation program than members of the information-only group (15.4% versus 5.4%). They were also more likely to quit within six months (20.9% versus 11.8%) and to remain nonsmokers six months after quitting (14.7% versus 5.0%) and 15 to 18 months after quitting (9.4% versus 3.6%).

In another study, which looked at financial incentives for weight loss, 57 obese volunteers were divided into three groups. The first did not get financial incentives to lose weight. The second group participated in a contract program that could pay each person between $0 and $252 a month depending on how much weight they lost. The third group participated in a lottery program that made each member who lost weight eligible to win up to $100 a day, though most prizes were lower.

By the end of the 16-week trial, the members of the contract and lottery groups had lost significantly more weight (14.0 and 13.1 pounds, respectively) than members of the comparison group (3.9 pounds). While participants gained weight again after the study, after 7 months the members of the two incentive groups weighed significantly less than at the start of the trial, while members of the comparison group did not.

Smoking cessation and weight loss are two of the most important lifestyle changes. They are also among the most difficult. These two recent studies tell us that financial incentives can help some people reach their goals, but monetary rewards alone can’t solve difficult health problems.

Read the full-length article: "Money talks: Financial incentives for health"