Annals of Health Law
STRATEGY AGAINST SMOKING
As a side note, the mortality rates of smokers who manage to quit before the
age of thirty-five years are similar to those of people who never smoked.223
Admittedly, the suggested time period does not offer a solution tailored to
each individual case. However, it constitutes an average peak that is easily
manageable and might in the worst case only prolong the incentivized non-smoking period more than necessary. Second, the probability of resuming
smoking after a break of fifteen years drops substantially. On the other
hand, participation in the program has to end at a certain point to prevent an
inefficient use of resources by providing rewards to participants who are not
at risk of starting to smoke again.
Additionally, the participants shall have the possibility to voluntarily
invest a discretionary amount of their own funds of up to $5,000 (Group A),
$2,500 (Group B) or $1,250 (Group C) that will be doubled in the
beginning. As with the rest of the credit balance, this amount will only be
disbursed at the end of the term or will be lost in the third case of smoking
Moreover, one might think of a modification for pregnant women. Given
the potential of adverse long-term effects on the child’s health,224 women
shall be further incentivized not to smoke during pregnancy. Besides
participating in the standard program, a pregnancy shall entitle women to a
credit entry of $1,000 on their special account. In contrast to the regular
credit balance, the $1,000 will be disbursed immediately after the child is
born – provided, of course, that the mother did not smoke.
1. Underlying Considerations from Behavioral Economics
The underlying considerations correspond with those outlined above225
for the program against smoking initiation. In addition, by allowing
participants to invest their own capital on top of the provided credit balance,
the model appeals to loss aversion226 Loss aversion is expected to have a
greater impact on the participants’ decision-making because their own
capital is on the line instead of an amount they receive from the ITAA
Mortality in Former Smokers, 85 J. NAT’L CANCER INST. 457 passim (1993); Richard Peto et
al., Smoking, Smoking Cessation, and Lung Cancer in the UK Since 1950: Combination of
National Statistics with Two Case-Control Studies, 321 BRITISH MED. J. 323 passim (2000);
Kenji Wakai et al., Decrease in Risk of Lung Cancer Death in Males after Smoking
Cessation by Age at Quitting: Findings from the JACC Study, 92 JPN. J. CANCER RES. 821
223. Doll, supra note 222, at 1523.
224. See, e.g., Knut-Olaf Haustein, Cigarette Smoking, Nicotine and Pregnancy, 37 INT.
J. CLIN. PHARMACOLOGY THERAPY 417 passim (1999); John M. Rogers, Tobacco and
Pregnancy, 28 REPRODUCTIVE TOXICOLOGY 152 passim (2009).
225. See supra Part III. A. 1.