BACKGROUND-AIM:
Research shows that financial incentives improve the success of stop smoking programmes. Financial incentives to stop smoking (FISS) programmes have been implemented internationally to encourage people who smoke to quit smoking. Irish research indicates that FISS are acceptable for national implementation provided that at risk social groups who can benefit from the initiative are effectively targeted to achieve high and sustainable quit rates. The primary objective was to co-design and subsequently implement a financial incentives programme to help people stop smoking, with input from community members and healthcare professionals. The implementation of this FISS scheme at 3 pilot sites will be formally evaluated through a Health Research Board funded study in partnership with the Royal College of Surgeons in Ireland.

METHODS:
Three co-design workshops were held in designated Sláintecare communities (areas designated as disadvantaged by the Irish Government) in Limerick, Dublin and Longford. A modified Nominal Group Technique approach was applied to encourage all participants to share their views on the potential structure of the financial incentive intervention and to reach a group consensus by the end of each workshop. 59 participants (including 26 community members) took part across the three workshops.

RESULTS:
The total potential incentive amount per person was set at €400 for the programme duration (12 months). Incentives are provided in the form of flexible shopping vouchers with physical card and digital options available. The frequency and schedule were set in line with existing quit service dates (Weeks 1, 2, 3, 4, 12, 26 and 52) and with incremental increases until €400 total is reached. Adults residing in the designated pilot areas that hold a General Medical Services Card (means-tested) are eligible to be offered stop smoking care that includes financial incentives. Non-smoking status must be verified at each episode of care by means of a breath carbon monoxide test. To date, 108 unique clients have been accepted into clinics across 3 pilot areas. 75% have set a quit date with 49% successfully quit at 4-weeks and 30% quit at 12-weeks. 191 vouchers have been issued to clients to date.

CONCLUSIONS:
The target population for this intervention are people that experience economic disadvantage and are at high risk of health inequalities due to smoking. Early analysis of stop smoking service data indicates that the target population is being effectively recruited into the FISS programme. 41% of clients in FISS clinics are unemployed or cannot work due to illness/disability. Over 33% of clients report having a mental illness and 36% report living with chronic disease.