Public Attitudes to Implementing Financial Incentives in Stop Smoking Services in Ireland

INTRODUCTION Financial incentives improve stop smoking service outcomes. Views on acceptability can influence implementation success. To inform implementation planning in Ireland, public attitudes to financial incentives in stop smoking services were measured. METHODS A cross-sectional telephone survey was administered to a random digit dialled sample of 1000 people in Ireland aged 15 years and older in 2022. The questionnaire included items on support for financial incentives under different conditions. Prevalence of support was calculated with 95% Confidence Intervals (CIs) and multiple logistic regression identified associated factors using Adjusted Odds Ratios (aORs, with 95% CIs). RESULTS Almost half (47.0%, 95% CI 43.9%-50.1%) supported at least one type of financial incentive to stop smoking, with support more prevalent for shopping vouchers (43.3%, 95% CI 40.3%-46.5%) than cash payments (32.1%, 95% CI 29.2%-35.0%). Support was similar for universal and income-restricted schemes. Of those who supported financial incentives, the majority (60.6%) believed the maximum amount given on proof of stopping smoking should be under €250 (median=€100, range=€1-€7000). Versus comparative counterparts, those of lower educational attainment (aOR 1.49 95% CI 1.10-2.03, p=0.010) and tobacco/e-cigarette users (aOR 1.43 95% CI 1.02-2.03, p=0.041) were significantly more likely to support either financial incentive type, as were younger people. CONCLUSIONS While views on financial incentives to stop smoking in Ireland were mixed, the intervention is more acceptable in groups experiencing the heaviest burden of smoking-related harm and most capacity to benefit. Engagement and communication must be integral to planning for successful implementation to improve stop smoking service outcomes. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement HSE Tobacco Free Ireland Programme ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Royal College of Physicians in Ireland (RCPI) Ethics Committee (RECAP 157) I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors