Annals of Health Law
STRATEGY AGAINST SMOKING
model suggested here is an experiment targeting obesity by Volpp et al. 142
because of its similar study design with regard to the lottery and its
foundation on insights from behavioral economics. The participants of the
group provided with daily lottery incentives, as well as those of the group
with a deposit contract and additional bonus incentives, performed
significantly better than the control group both over the course of the
experiment, and shortly after the 16-week study. 143 However, participants
regained weight quickly after the experiment ended. 144 An interesting aspect
is that the average costs were considerably higher for the deposit contract
group ($378.49) than for the lottery incentive group ($272.80). 145
D. Payment for Non-Smoking?
One apparent problem with an incentivizing mechanism that distributes
money for not smoking is the notion that people are rewarded to give up a
habit they themselves chose to develop, while others who resisted or
managed to quit on their own receive nothing. The latter group may
perceive such treatment as unfair. 146 What seems to be understandable from
the individual’s point of view can be disregarded in light of the
mechanism’s overall potential to diminish the number of smokers. Thus,
outweighing the individual’s perception of being disadvantaged. In
addition, providing adult non-smokers with incentives for refraining from
doing something they do not want to do is evidently redundant and a waste
Naturally, the regulatory paternalism approach is a another major
concern, in particular because of the solicitude of the state trying to
influence the private way to lead one’s life and acting coercively or even
potentially discriminatorily. Although incentives to encourage people to
behave in a certain way only constitute a rather alleviated “libertarian
paternalism,” 147 the state undeniably tries to influence the individual’s
behavior and explicitly stipulates a specific behavior, non-smoking, as
desirable. A coercive or discriminatory effect mainly depends on the
specific design of the mechanism. For instance, if the reward is significant,
Smoking Trial in Chronic Obstructive Pulmonary Disease Patients, 119
PSYCHOPHARMACOLOGY 193 passim (1995); Michel Gomel et al., Work-Site Cardiovascular
Risk Reduction: A Randomized Trial of Health Risk Assessment, Education, Counseling, and
Incentives, 83 AM. J. PUB. HEALTH 1232, 1232-36 passim (1993).
142. Volpp et al., infra note 172, passim.
143. Volpp et al., infra note 172, at 2635.
144. Volpp et al., infra note 172, at 2635.
145. Volpp et al., infra note 172, at 2635.
146. Cf. Redesigning Incentives, supra note 107, at 390.