Annals of Health Law
STRATEGY AGAINST SMOKING
efficient cost allocation.
Establishing a non-accessible account with a continuously increasing
credit balance that will only be disbursed at the age of twenty-five shall
provide an additional incentive in the form of the expectation of a
significant amount of money. Structuring the program to start with a
substantial amount of money that is increased disproportionally within the
first eighteen months and then continuously supplemented by a smaller sum
will exploit the participants’ loss aversion. Although they cannot access the
money yet, the participants should perceive the bank account as part of their
assets, which they would give up in case of smoking. The accumulation of
a substantial sum in a short period of time shall make the loss even more
painful. Of course, the impact is weakened by the present bias.
Informing the participants about the lottery rewards they would have
received had they not been smoking or the amount of the lost credit balance
is meant to appeal to the regret aversion. 176 It shall amplify the anticipated
regret, circumvent the desire to avoid it and thereby influence decision-making. Given the cheap medium of mass email communication and the
possibility of automatically generated notifications, this feature can be
implemented at very low costs but may nevertheless have a significant
impact on the participants’ future choices.
Automatically re-enrolling eligible participants in the program against
smoking initiation in yearly intervals is meant to appeal to the default
bias, 177 and is based on the assumption that an opt-out model retains more
participants than an opt-in model.
2. Review and Verification of Smoking Status
The suggested distribution of rewards cannot be based on the mere word
of participants that they have not been smoking. The risk of abuse would
be too high, particularly given that clinical studies178 show that even
without a potential reward in play participants tend to be dishonest about
whether they have been smoking. Hence, the implementation of the new
model crucially depends on a reliable method to verify whether a
participant has refrained from smoking. This article suggests introducing a