Annals of Health Law
STRATEGY AGAINST SMOKING
and twenty-five years is the critical age for smoking initiation and
developing a smoking habit. 154 Potentially eligible participants shall be
automatically included in the program every year but will be excluded if
they do not attend a scheduled test155 for evaluation of the smoking status.
However, it is entirely the participant’s decision to participate.
The lottery shall take place each Monday to offer the reward
immediately after the weekend’s particularly tempting social events. The
lottery’s conceptual design is similar to the one developed by Kevin Volpp
et al. in their clinical trial to reduce obesity. 156 Each participant chooses a
two-digit number. He may change the number up to every two months or
keep his number for a year before he has to choose again. A two-digit
number is randomly generated each Monday. If the first or the last digit of
the generated number corresponds with a participant’s first or last digit, e.g.
the participant chose “ 35” and the generated number is “ 37” or “ 15”, the
participant will receive a small payoff. If his exact number is generated, he
will receive a payoff ten times larger than the small payoff. The
participants shall be informed about the results of the weekly lotteries via
email. If they have been smoking, the email will inform them about the
sum they would have received had they not.
All participants will be assigned to specific groups. One major
determining factor of the groups will be based on age, so that all
participants from ten to fourteen, from fifteen to nineteen, and from twenty
to twenty-five will form one group. This shall ensure that the preferences
associated with the participants’ age can be taken into consideration. For
instance, the smallest amount of money that can function as an incentive
increases with age. Because of the smaller amount of money a ten-year-old
typically has access to, he or she may be happier about an additional five
dollars every week than a twenty-two-year- old with a job may be. In
addition, a breakdown based on age easily allows for a more tailored
distribution of non-monetary economic incentives.
The second, even more important determining factor will be based on the
participant’s statistical likelihood to start smoking. Despite the fact that the
statistical likelihood can only provide a rough indication of risk, it
nevertheless contributes to a better allocation of funds and prevents an
unnecessary distribution of rewards among groups with a very low risk of
smoking. Two groups shall be formed: Group A, shall include participants
with a significant statistical tendency for smoking. Group B, shall be
composed of those with an average or below average risk of becoming a
