Cash incentives are commonly used to change behaviors in different situations—from parents trying to control their children’s behaviors to government programs that promote certain behaviors among its citizens. While nicotine substitutes and counseling have been dominant in smoking cessation programs in developed countries, these programs are costly and often not accessible for the rural poor in developing countries. As an alternative approach, we designed a commitment contract that provides financial incentives for the smokers to quit smoking and evaluate this product with the cooperation of Green Bank of Caraga, a rural bank in the Philippines.

CARES (Committed Action to Reduce and End Smoking) is a commitment savings program. Smokers who wish to quit smoking are encouraged to deposit an increasing percentage of the money they ordinarily spend on cigarettes into their CARES accounts for six months. Deposits are collected every week by field staff who motivate clients to continue reducing smoking behavior. The client cannot withdraw any money during the deposit period; the balance is what is at stake if the client should fail to quit. At the end of six months, the client submits to a urine test to confirm smoking cessation. Only by passing the test can s/he access the money in the CARES account. Otherwise, the account is closed and the money donated to a charity.

In this study, smokers are approached in public places by marketers who administer a smoking survey. After the survey, the smoker is randomly assigned with equal probability to one of three groups: (i) CARES group: respondents are offered CARES; (ii) Cues group: respondents are offered aversive signaling devices called cues (cues depict negative consequences of smoking such as black lungs and secondhand smoke and are intended to be placed in locations where the respondent usually smokes); (iii) Control group: respondents are offered neither CARES nor cues. All respondents are followed up with at the six-month and one-year points to track smoking status.