AbQuit

At Crikey, Simon Chapman suggests an intriguing health policy idea: why not pay Indigenous Australians to quit smoking? At the very least, I think this one merits a randomised trial. The critics might say that it will induce start-quit cycles, but that’s perfectly testable too.

Update: Harry Clarke, who is much more of an expert on this issue than me, has a longer post on the topic.

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11 Responses to AbQuit

  1. If they do a randomised trial of a similar policy for non-Indigenous Australians, I’ll volunteer!

    As I understand it, start-quit cycles are pretty inevitable. I quit for 9 months once and was told by my dr that would give me a better chance of quitting for longer or for good next time I tried.

  2. Simon Chapman says:

    I saw a presentation recently which suggested that the average number of “serious” quit attempts before lasting success was 12 (these don’t count Saturday morning statements of intent which collapse by that night). What it means for such an experiment would be that you would have to set a medium to long term quit period that had to be reached before payment was made. This might be 3-6 months. There would be some relapse, for sure, but there would also be a lot of sustained cessation. Rudd has given $14.5m to indigenous cesstion. If $500 was offered to to anyone who tested positive for cotinine (a nicotine metabolite) at time 1 and then negative at any time within a 3-6 month period later (purposefully vague to guard against planned temporary quitting to rort the scheme by “quitting” a few days before your known re-test date) then $14.5m would “buy” 29,000 quitters.

  3. Andrew Leigh says:

    Simon, the random audit date idea is a clever one.

  4. Jono says:

    We already tax the heck out of cigarettes.

    Did anybody bother questioning how you would actually enforce such a ridiculous scheme of paying people because they tell you they’ve quit smoking ?

  5. hc says:

    These schemes have worked quite well for other drugs such as cocaine. Moreover the rewards were not large. A major benefit was their short-term orientation – you only had to make it a week or so to get a rewards rather than an indefinite intertemporal commitment which can prove difficult. Helps foster commitment & self-control.

  6. Simon Chapman says:

    Jono — easy. You don’t reply on self-report. You register people to be eligible to quit by confirming at entry that they are smokers by a simple saliva test. You can also require them to have someone of trust confirm that they are actually smokers and not a non-smoker who has had a few smokes to get their salivary nicotine levels to show they smoke. There is a a lot of experience in doing this via quit & win lotteries.

    So at 3-6 months, you go back unannounced, bowl up to the entrants and if they show negative for smoking, hand over $250 with another $250 another 3 months later if they are still off the weed.

    We think nothing of coughing up that sort of money routinely for subsidized quit smoking medication which has a dismal track record. This way, the state only pays out when the person has actually stopped.

  7. anon says:

    why not pay Indigenous Australians to quit smoking?

    Why would you not pay everyone to quit? would the one drop of blood apply here too

  8. anon says:

    Because it’s patronizing to identify Indigenous Australians as requiring “special care” over smoking, short medical evidence that smoking is *particularly* damaging to them. Surely selective incentives should be provided to all smokers, or not at all. Or if you wanted to means test because you expect greater value from bribing poorer people to quit, then all poorer people should have access to the bribe.

    This is for two reasons. First, it is inequitable. Second, without doing so you are intervening in Indigenous Australians’ lives, and *not* others’, with no good justification. This is a dubious moral enterprise at best.

  9. Patrick says:

    Well, except that arguably we have a greater responsibility vis-a-vis Aboriginal Australians than vis-a-vis ordinary Australians.

    Andrew, you must have seen this from either Alex Tabarrok or Dani Rodrik – surely that stirred the depths of your economist’s heart?

  10. Jono says:

    Maybe this really is a fantastic incentive that will change human behaviour!

    Millions of people will need to take up smoking in order to quit and receive the payment.

    Whats that about moral hazard ?

  11. ChrisPer says:

    Well, I find it hard to imagine I owe a special duty to handle Aboriginals smoking problems for them. The ‘special duty’ was once called the White Man’s Burden, I believe? Most unfashionable, soon people will agree to rescue children from rape and murder using police and soldiers too.

    Except that it was a Howard policy…

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