# Financial incentives to help people with cognitive impairment quit smoking

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2020 · $383,718

## Abstract

PROJECT SUMMARY/ABSTRACT
Currently, among Americans 65 years and older, about 20-25% have mild cognitive impairment and about 10%
have dementia. Smoking has been linked with an increased risk of dementia development and progression.
Quitting smoking can slow the progression of dementia by decreasing many of the risk factors for dementia
progression such as cardiovascular disease, hypertension, atherosclerosis, atrial fibrillation, and stroke. In
addition to the risk factors of disease progression, smokers with dementia represent a particularly high risk
smoking population due to an elevated risk of accidents, residential fires and injury. Unfortunately, cognitive
impairment often precludes smokers with dementia from participating in trials of most cessation treatments.
While most people with dementia do not smoke, there are a significant number that still do. Interventions are
needed in this challenging but high-risk population, particularly since smoking cessation is one of the few
interventions that actually affects the rate of dementia progression. However, no smoking cessation programs
currently exist for people with dementia. Financial incentives for motivating changes in health behavior,
particularly for smoking and other morbid habits, are increasingly being tested by health insurers, employers,
and government agencies. However, a key unanswered question is how to structure these incentive programs
to maximize their effectiveness in patients with dementia. The goal of this supplement is to leverage the
resources of an ongoing financial incentive smoking cessation trial in hospitalized patients to adapt and test the
financial incentive smoking cessation interventions for smokers with dementia.
We propose a 1-year administrative supplement to use the financial incentive smoking cessation interventions
from the Financial Incentives for Smoking Cessation Treatment II (FIESTA II) trial and adapt it for patients with
dementia (Aim 1). The intervention will be adapted for dementia patients by consulting with people living with
cognitive impairment and care partners and pilot tested. The effectiveness of the dementia-specific financial
incentive interventions will then be tested in a 3-arm randomized controlled study comparing 1) goal-directed
financial incentives and 2) outcome-based financial incentives versus 3) enhanced usual care for achieving
smoking cessation (Aim 2). For this supplement, we will focus on hospitalized smokers that screen positive for
cognitive impairment, but would normally be excluded from FIESTA II study of financial incentives for
hospitalized smokers.

## Key facts

- **NIH application ID:** 10119946
- **Project number:** 3R01DA045688-02S1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** Joseph Abiodun Ladapo
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $383,718
- **Award type:** 3
- **Project period:** 2019-02-15 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10119946

## Citation

> US National Institutes of Health, RePORTER application 10119946, Financial incentives to help people with cognitive impairment quit smoking (3R01DA045688-02S1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10119946. Licensed CC0.

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