Tobacco cessation contests

Evidence Rating  
Evidence rating: Insufficient Evidence

Strategies with this rating have limited research documenting effects. These strategies need further research, often with stronger designs, to confirm effects.

Health Factors  
Date last updated

In tobacco cessation contests, participants are encouraged to quit using tobacco by a particular date or during a specific time period; successful participants are eligible for raffles, lotteries, or prize drawings, which may include financial payments or other rewards. Often called Quit & Win contests, tobacco cessation contests may be part of larger cessation interventions with counseling or pharmacological treatments (e.g., nicotine replacement therapy (NRT))1. Competitions can occur at worksites or within the broader community2, 3.

Note: The term “tobacco” in this strategy refers to commercial tobacco, not ceremonial or traditional tobacco. County Health Rankings & Roadmaps recognizes the important role that ceremonial and traditional tobacco play for many Tribal Nations, and our tobacco-related work focuses on eliminating the harms and inequities associated with commercial tobacco.

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Reduced tobacco consumption

Potential Benefits

Our evidence rating is not based on these outcomes, but these benefits may also be possible:

  • Increased quit rates

What does the research say about effectiveness?

There is insufficient evidence to determine whether tobacco cessation contests reduce smoking when implemented alone3. Available evidence suggests that contests may help some smokers quit but are not likely to affect community smoking rates4. Contests may be part of broader cessation programs with counseling or pharmacological treatments5, which can decrease tobacco use in the short-term5, 6. Financial incentives may boost long-term smoking cessation rates, with no noticeable difference between small or large cash rewards7. An assessment of multi-component Quit & Win contests at 19 universities suggests that participation in multiple contests may increase the likelihood of quitting1 and may be cost-effective8. However, additional evidence is needed to confirm the effects.

How could this strategy impact health disparities? This strategy is rated no impact on disparities likely.
Implementation Examples

Tobacco cessation contests use incentives or rewards to encourage participants to quit using tobacco by a particular date and can occur in workplaces2, university campuses8, or within the broader community3. For example, in 2021, Above + Beyond Cancer, an Iowa-based non-profit, ran a tobacco cessation contest in which teams representing small towns competed in a two-month long cessation challenge, with a prize of up to $50,000 for community improvements9.


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1 Thomas 2016 - Thomas JL, Luo X, Bengtson J, et al. Enhancing Quit & Win contests to improve cessation among college smokers: A randomized clinical trial. Addiction. 2016;111(2):331-339.

2 CDC-Evidence Informed State Workplace 2017 - Centers for Disease Control and Prevention (CDC). Division for Heart Disease and Stroke Prevention (DHDSP). What could be addressed in an evidence-informed state workplace health promotion law? Atlanta: Centers for Disease Control and Prevention; 2017.

3 CG-Tobacco - The Guide to Community Preventive Services (The Community Guide). Tobacco.

4 Cochrane-Fanshawe 2019 - Fanshawe TR, Hartmann-Boyce J, Perera R, Lindson N. Competitions for smoking cessation. Cochrane Database of Systematic Reviews. 2019;(2):CD013272.

5 Cochrane-Cahill 2014 - Cahill K, Lancaster T. Workplace interventions for smoking cessation. Cochrane Database of Systematic Reviews. 2014;(2):CD003440.

6 Ledgerwood 2014 - Ledgerwood DM, Arfken CL, Petry NM, Alessi SM. Prize contingency management for smoking cessation: A randomized trial. Drug and Alcohol Dependence. 2014;140:208-212.

7 Cochrane-Notley 2019 - Notley C, Gentry S, Livingstone-Banks J, et al. Incentives for smoking cessation. Cochrane Database of Systematic Reviews. 2019;(7):CD004307.

8 Popp 2018 - Popp J, Nyman JA, Luo X, et al. Cost-effectiveness of enhancing a Quit-and-Win smoking cessation program for college students. European Journal of Health Economics. 2018;19(9):1319-1333.

9 Above and Beyond Cancer - Above+Beyond Cancer. The $50,000 Cold Turkey Challenge. Championing for a healthier, nicotine-free Iowa.