Chapter 10 342 (NRT) as part of the training. No NRT is provided in the trial but participants are free to use an NRT of their choice. During each session, exhaled carbon monoxide (CO) measurements (see outcomes for more information) are used as a motivator to stay abstinent. The SineFuma group-based training is recognised as an efficient lifestyle intervention by the Dutch Government,16 and participation costs are reimbursed by basic insurance. As such, the control arm can be considered as usual care. If a portion of the costs are at the employee’s own expense through the deductible, employers have agreed to pay for the training. Incentives The difference between intervention and control conditions lies within the provision of incentives. Participants in the intervention arm who remain continuously abstinent following the joint quit attempt are eligible to receive incentives according to a fixed time schedule. Incentives are provided as vouchers representing monetary value. Vouchers can be spent at online web-shops or on events such as a high tea in a local café or a night at a hotel etc. Vouchers cannot be spent on tobacco products. The first incentive is provided directly after the group-based smoking cessation training, marking the moment from which participants have to remain abstinent independently. In order to personalise incentives, four different incentive schemes are offered, which participants are free to choose from. Across the different schemes, the monetary value of the incentives varies over time, and the potential total financial reward differs. The schemes are as follows (see figure 1): 1. The standard scheme. Analogous to the CATCH trial,13 vouchers with a monetary value of €50, €50, €50, and €200 are offered upon validated abstinence at t=0 months (i.e. directly following the final smoking cessation training session), t=3 months, t=6 months, and t=12 months, respectively. Hence, the maximum total amount of incentives that can be earned is €350. 2. The descending scheme. Offers vouchers with a monetary value of €150, €100, and €50 upon validated abstinence at t=0 months, t=3 months, and t=6 months, respectively. No further incentives are provided at t=12 months. The maximum total amount of incentives is €300. 3. The ascending scheme. Offers vouchers with a monetary value of €50 and €350 upon validated abstinence t=6 months and t=12 months, respectively. No incentives are provided at t=0 and t=3 months. The maximum total amount of incentives is €400.
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