CVS Caremark has rebranded itself over the past year as a pharmacy that cares about its customers' health, at least when it comes to how it approaches those who smoke cigarettes — in February 2014, it stopped selling tobacco products, the first retail pharmacy to make that move. Recently, it took part in a study testing smoking cessation techniques, and found bribery could help people quit, but not in the way you might think.

Researchers from the Perelman School of Medicine at the University of Pennsylvania found that bribery worked only when participants were required to pay an up-front cash deposit, and risk losing it if they relapsed. If they didn’t, then they’d get their money back plus a cash reward of roughly $800, Reuters reported. The researchers found these techniques were about twice as effective as simply offering a monetary reward for staying away from cigarettes and five times as effective as giving out free smoking cessation aids like the nicotine replacement therapy.

“It leveraged people’s natural aversion to losing money,” lead author Dr. Scott Halpern told Reuters.

Nearly seven out of 10 current smokers in the United States admit to wanting to quit. However, it’s incredibly hard. Withdrawal symptoms, stress, and weight gain — caused by hunger, one withdrawal symptom — can all lead to relapse, no matter how much a person wishes to quit. It often takes several attempts, which is why the current study tested out various techniques.

For the study, researchers tested five different smoking cessation techniques on 2,538 employees at CVS retail stores. Four of them offered different kinds of incentives while the last simply provided smoking cessation guides and resources, as well as nicotine replacement therapy and a behavior modification program if the person had health insurance.

Far more participants were willing to enroll in the incentive programs promising money for abstinence. However, when compared to the group that paid a deposit, their success rates were much lower — 16 percent stayed smoke-free for six months compared to 52 percent. In the group that took part in typical quitting techniques, only six percent stayed smoke-free.  

The research will not only help CVS employees lead healthier lives, but also save the company money in health care costs, Reuters reported. Some research suggests employees who smoke cost companies an extra $4,000 to $6,000 a year. Incentive programs with up-front deposits may play on employees’ psychologies, helping them to quit. “The fact that people actively seek to minimize loss is one of several psychological insights that can help supercharge incentive programs without increasing their costs,” Halpern said.

Source: Halpern S, French B, Small D, et al. Randomized Trial of Four Financial-Incentive Programs for Smoking Cessation. JAMA. 2015.