Health

Smokers Have Better Luck Quitting When Own Money Wagered

Published

11 years ago

May 14, 2015

In this Tuesday, June 3, 2008 file photo, an employee smokes a cigarette at a bar and restaurant in Harrisburg, Pa. In a study released Wednesday, May 13, 2015, smokers with $150 of their own money at stake were far more likely to quit than smokers who didnt have to wager their money to get cash rewards. "A bit of a stick was much better than pure carrot," said the study's lead author, Dr. Scott Halpern of the University of Pennsylvania. But heres the catch: Few people were willing to bet on themselves. Nearly everyone who was offered the rewards-only option, though, signed up for a stop smoking program. (AP Photo/Carolyn Kaster)

In a study released Wednesday, May 13, 2015, smokers with $150 of their own money at stake were far more likely to quit than smokers who didnt have to wager their money to get cash rewards. (AP Photo/Carolyn Kaster)

Mike Stobbe, ASSOCIATED PRESS

NEW YORK (AP) — When it comes to offering cash to get smokers to quit, more people go for the carrots than the stick — but the stick gets better results.

In a study released Wednesday, smokers with $150 of their own money at stake were far more likely to quit than smokers who didn’t have to wager their money to get the cash rewards.

“A bit of a stick was much better than pure carrot,” said the study’s lead author, Dr. Scott Halpern of the University of Pennsylvania.

But here’s the catch: Few people were willing to bet on themselves. Nearly everyone who was offered the rewards-only option, though, signed up for a stop smoking program.

As employers try to hold down health care costs, growing numbers of them have been using financial incentives to encourage workers to quit smoking or get healthier in other ways. But there’s been relatively little research on what works best, said senior author Dr. Kevin Volpp.

The Penn researchers collaborated with CVS Health, the second largest U.S. drugstore operator, for the study. About 2,500 smokers took part — CVS employees, their relatives or friends.
THE INCENTIVES

Past research has found money is persuasive. Volpp and his colleagues tried to see what difference it made if employees stood not only to win money for quitting, but also to lose money.

About 1,000 smokers were offered the chance to win up to $800 if they could quit for six months. Participation was high — about 90 percent signed up.

Another 1,000 were asked to put $150 down as a deposit. It they quit for six months, they would get their $150 back plus $650 — a total of $800. Only 14 percent took that offer.

Another group of about 500 were offered no cash incentive, but did get the company’s standard offering of counseling and nicotine replacement therapy.
THE OUTCOME

The few that put in their own money were a committed bunch. About half of them made it six months without a cigarette. That was a much better than the 17 percent of the rewards-only group that made it to the finish line.

But there were so many people in the rewards-only program that the actual number who quit in that group was much higher — 156, compared to 78.

Only 28 of the people offered no cash incentives quit — a measly 6 percent.

To get the largest number of people to stop, “it looks like the better bet might be for employers to supply pure reward,” said Cliff Douglas, the American Cancer Society’s vice president for tobacco control. He was not involved in the research.

The study was published in Thursday’s New England Journal of Medicine.
TOO-HIGH STAKES

The study’s authors say there’s a compelling story in the success rate for the smokers who had money on the line. But they also say the $150 deposit apparently scared many away.

One participant, Camelia Escarcego of Rialto, California, said she is unemployed and wouldn’t have been able to come up with the deposit. Her sister works for CVS and Escarcego ended up in the rewards-only group.

A 12-year smoker, Escarcego, 55, said the hundreds of dollars was enough motivation.

“That helped me to have a little bit of money in my pocket,” she said.

Next month, CVS is to launch a quit smoking program for its 200,000 employees that will require a lower deposit of $50 and will award $700 to those who quit for a year.

___

Online:

Journal: http://www.nejm.org.
Copyright 2015 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

###

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COMMENTARY: The Biases We Don’t See — Preventing AI-Driven Inequality in Health Care

For decades, medicine promoted false assumptions about Black bodies. Black patients were told they had lower lung capacity, and medical devices adjusted their results accordingly. That practice was not broadly reversed until 2021. Up until 2022, a common medical formula used to measure how well a person’s kidneys were working automatically gave Black patients a higher score simply because they were Black. On paper, this made their kidneys appear healthier than they truly were. As a result, kidney disease was sometimes detected later in Black patients, delaying critical treatment and referrals.

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February 10, 2026

Oakland Post

Sen. Akilah Weber Pierson, M.D (D-San Diego). File photo.

By Sen. Akilah Weber Pierson, M.D., Special to California Black Media Partners

Technology is sold to us as neutral, objective, and free of human flaws. We are told that computers remove emotion, bias, and error from decision-making. But for many Black families, lived experience tells a different story. When technology is trained on biased systems, it reflects those same biases and silently carries them forward.

We have seen this happen across multiple industries. Facial recognition software has misidentified Black faces at far higher rates than White faces, leading to wrongful police encounters and arrests. Automated hiring systems have filtered out applicants with traditionally Black names because past hiring data reflected discriminatory patterns. Financial algorithms have denied loans or offered worse terms to Black borrowers based on zip codes and historical inequities, rather than individual creditworthiness. These systems did not become biased on their own. They were trained on biased data.

Healthcare is not immune.

These biases were not limited to software or medical devices. Dangerous myths persisted that Black people feel less pain, contributing to undertreatment and delayed care. These beliefs were embedded in modern training and practice, not distant history. Those assumptions shaped the data that now feeds medical technology. When biased clinical practices form the basis of algorithms, the risk is not hypothetical. The bias can be learned, automated, and scaled.

For us in the Black community, this creates understandable fear and mistrust. Many families already carry generational memories of medical discrimination, from higher maternal mortality to lower life expectancy to being dismissed or unheard in clinical settings. Adding AI biases could make our community even more apprehensive about the healthcare system.

As a physician, I know how much trust patients place in the healthcare system during their most vulnerable moments. As a Black woman, I understand how bias can shape experiences in ways that are often invisible to those who do not live them. As a mother of two Black children, I think constantly about the systems that will shape their health and well-being. As a legislator, I believe it is our responsibility to confront emerging risks before they become widespread harm.

That is why I am the author of Senate Bill (SB) 503. This bill aims to regulate the use of artificial intelligence in healthcare by requiring developers and users of AI systems to identify, mitigate, and monitor biased impacts in their outputs to reduce racial and other disparities in clinical decision-making and patient care.

Currently under consideration in the State Assembly, SB 503 was not written to slow innovation. In fact, I encourage it. But it is our duty must ensure that every tool we in the healthcare field helps patients rather than harms them.

The health of our families depends on it.

About the Author

Sen. Akilah Weber Pierson (D–San Diego) is a physician and public health advocate representing California’s 39th Senate District.

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As California Hits Aging Milestone, State Releases Its Fifth Master Plan for Aging

“California’s Master Plan for Aging started a powerful movement that is shaping the future of aging in our state for generations to come,” Gov. Gavin Newsom said in a statement, calling the initiative a “future-forward” model delivering real results for older adults, people with disabilities, and their families.

Published

4 weeks ago

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By Bo Tefu, California Black Media

On Jan. 27, California released its Fifth Master Plan for Aging Annual Report,titled “Focusing on What Matters Most,” outlining the state’s progress and priorities as its population rapidly grows older.

The report, issued by the California Health and Human Services Agency (CalHHS), provides updates on the Master Plan for Aging’s “Five Bold Goals”: housing, health, inclusion and equity, caregiving, and affordability.

The report comes as Californians aged 60 and older now outnumber those under 18 for the first time, a demographic shift expected to accelerate over the next decade.

Launched in 2021, the Master Plan for Aging takes a “whole-of- government” and “whole-of-society” approach, coordinating state agencies, local governments, community organizations, and private partners. The annual report highlights significant milestones, including more than 100 California communities joining AARP’s Age-Friendly Network and $4 million in state funding awarded to local organizations to develop aging and disability action plans in 30 communities statewide.

The report also underscores California’s leadership at the national level, noting that dozens of states have followed its example and that federal legislation inspired by the plan was reintroduced in the U.S. Senate in December 2025.

CalHHS Secretary Kim Johnson emphasized the plan’s focus on equity and resilience amid ongoing challenges.

“The Master Plan for Aging continues to provide a vision, a focus, and a platform for collaboration,” Johnson said. “Equity is at the center of all that we do.”

Looking ahead, the report notes that by 2030, one in four Californians will be age 60 or older, positioning the Master Plan for Aging as a central framework for meeting the state’s long-term social, economic, and health needs.

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Candidates Vying for Governor’s Seat Debate at Ruth Williams–Bayview Opera House in San Francisco

The gubernatorial debate participants included Antonio Villaraigosa, former Los Angeles mayor; Matt Mahan, San Jose mayor; Betty Yee, former California state controller; Xavier Becerra, former U.S. Secretary of Health and Human Services, and attorney general of California; Steve Hilton, political commentator and political adviser; Tom Steyer, entrepreneur, and Tony Thurmond, California’s superintendent of public instruction.

Published

4 weeks ago

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Oakland Post

The gubernatorial debate was hosted by KTVU’s Greg Lee, KTTV’s Marla Tellez and KTVU’s Andre Senior. The candidates are (l.-r.): Xavier Becerra, Steve Hilton, Matt Mahan, Tom Steyer, Tony Thurmond, Antonio Villaraigosa, and Betty Yee.

By Carla Thomas

On Tuesday, Feb. 3, seven candidates took the stage at the historic Ruth Williams–Bayview Opera House in San Francisco for the gubernatorial debate, hosted by the Black Action Alliance (BAA) in partnership with KTVU and sister station KTTV Fox 11 in Los Angeles.

For many voters, it marked a first opportunity to hear directly from several candidates seeking to lead the nation’s most populous state.

Crucial topics and issues addressed throughout the debate included housing, crime, immigration, climate change, health care and homelessness.

The debate was moderated by KTVU political reporter Greg Lee alongside KTVU’s Andre Senior and KTTV Fox 11’s Marla Tellez.

Candidates also addressed inflation and the rising costs across the state, impacting everything from groceries to childcare and health care.

Thurmond vowed to generate 2.3 million units of housing by placing 12 units on each parcel of available land in the 58 counties of California. Steyer agreed that billionaires should pay their fair share of taxes.

Hilton wanted to cut taxes, help working-class families, and end the Democrats “climate crusade and insane regulations.”

Yee offered a more transparent governmental approach with accountability, given the state’s debt.

Gonzalez said, “This debate was a great way to see who has great ideas and who has substance.”

“It’s important to have the debate within a community that requires the most,” said business leader Linda Fadekye.

Attendees included State Controller Malia Cohen, representatives of the National Coalition of 100 Black Women, the National Coalition of 100 Black Men, the San Francisco African American Chamber of Commerce, and Black Women Organized for Political Action, among others.

Event host, the Black Action Alliance (BAA) was established to amplify the voices of the Bay Area’s Black community, whose perspectives have too often been overlooked in politics and public policy.

Loren Taylor, CEO of BAA, said it was important to bring the event to the Bayview in San Francisco and shared his organization’s mission.

“The Black Action Alliance (BAA) stands for practical, community-driven solutions that strengthen public safety, address homelessness, support small businesses, expand affordable housing, and ensure access to quality education—issues at the heart of the Black experience in the Bay Area,” said Taylor.

California’s primary election will take place on June 2 and the general election will take place on Nov. 3.