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Friday, 1 October 2010

How can people be motivated to make better health choices?

The National Institute for Clinical Excellence (Nice) is considering ways to persuade people to take better care of their health, due to the considerable impact that unhealthy habits are having on the NHS.

The NICE study examined a series of proposals, including one in Kent which pays dieters up to £425 for losing weight and another in Scotland which gives pregnant women shopping vouchers worth up to £650 for quitting smoking.

According to the proposals being considered by the health watchdog for England and Wales - people could be given cash incentives to encourage them to give up smoking or to lose weight.
  • Can cash incentives motivate people to make better health choices?
  • Are there better ways to encourage people to take care of their health or we are now at our last resort – hard cash?
  • Would offering money as an incentive to improve health be cost-effective for the NHS or would the money be better spent elsewhere?
  • Is it the right way forward?
You, as one of those professionals who work in the front line of helping people, are qualified better then anyone to answer these questions on the basis of your experience. Your opinion is invaluable and needs to be heard. We have created a simple poll were you can make your view known in two seconds:

Please vote – we will make sure that your answers are known to those who make decisions on the matter.
Please feel free to send us your views on the matter as well as to post comments in the comments box of the poll or on our Psychology & Psychotherapy Blog.

This is an important topic closely linked to our training on Motivational Interviewing and Beyond ( and we will definitely address this issue as part of our course discussion. However, we would like to give all of you the opportunity to express your opinion whether you are taking part in the course or not.

Looking forward to hearing from you.


  1. I have never heard of such a stupid idea. Nobody helped me to lose weight, I just did it

  2. Maybe the people receive the money and after is back to the unhealthy habiis.

  3. Most interesting subject, for the past 12 years as a counsellor of the bereaved and elderly, health and well being often crops up in the session.
    In such sessions I try to make the client aware that we have to be responsible for our own well being whether it be emotional or physical.
    Personaly I cannot see the benefit of handing out cash to an individual, apart from the odd case, would make any difference. It seems like bribery and can only last until the money runs out.
    I do believe in counselling of any discipline is the most effective way of makeing a client aware of what they are doing to themselves and learn to be more positive about there own well being.
    Regards. R.P., mbacp

  4. Dear Julia,
    I would like to add a few more comments. It seems like a last resort measure to offer cash incentives once the horse has well and truely
    bolted. It is well documented that healthwise UK was at it's best in the days of rationing. A modern version of this concept is worth piloting in order to ascertain both it's acceptance and success. Given the current economic climate and more individuals growing their own produce it may be worth considering incentivising growing own produce and perhaps cooking skills which are diminishing by the day due to our fast food and ready made culture and a lack of hand me down recipes.

    Using CBT is one way forward in order to promote permanent lifestyle changes. It may also be an idea to monitor an individuals' health more closely and ensure that everyone has a standard blood test once every 2
    years from the age of 18. This would also increase our knowledge and understanding from a health trends point of view. In order to make sure that everyone takes this up perhaps a large fine could be the incentive which would make sure that as a population everyone attended. It could be rolled out via the workplace or universities etc..

    I would be very keen to look at the results based on any long term studies which have used financial incentives. I would also be very keen to set up and conduct a study which considered rationing certain foods and to study it's long term effects.

    I appreciate that you are probably fairly busy however I hope that this is helpful and I look forward to hearing from you.

    Kind Regards,

  5. Hi Skills Development Service Ltd

    Here is a list of comments from colleagues in the Learning & Development Team

    - Would it not be better to use talking therapies to explore what is behind addictions for the individual?

    - Monitoring if money is given. How would this be done?

    - Payment:- If you lose weight for money or stop smoking for money how will you be monitored so you stay away from re-starting the addiction. If you put weight back on or start smoking again would you have to pay the money back?

    - If we create a yoyo effect are we not contributing to even worse health problems?

    - If there is montoring is this another way of 'Big Brother' watching over us?

    - Giving money is a 'Quick Fix' approach and it does not work!

    - This is discrimination against Slim people and people who are non-smokers!

    - Taking responsibility for your own health should not be done with Bribary!

    - This is an irrisponsible use of Public Monies and dreadful to even consider in the current economic climate, as lots of people are losing there jobs & services are being cut!

    - Who is saying that underwieght people and people who don't smoke are healthier? I have known people who are slim, don't smoke, don't drink and are active die due to a massive heart attack!

    I hope these comments from coleagues help contribute to your research?


  6. Having given up smiking AND lost 5 and a half stone over the past 2 years, I do not believe that cash incentives will help anyone do either. From personal experience, you have to be in the right mindset to do these things. CBT helped me with the weight loss - as did education regarding food. I think this is half the problem. People are so confused with food: what's good, what's bad, what's a right portion? At age 37 I didn't know these things until I was helped.
    As for the smoking - good old NHS stop smoking services.
    Can I claim my £1075 now please???

    Aside from this, how will people be selected and how will the scheme be monitored? I might tell you I've given up smoking - but how do you know? Do I have to repay the money if I start again? Will I have to have a BMI of over 35 before you'll consider paying me. I'm sure I could eat my way back up there again!!

    I just feel that there are better, more effective ways to spend this money - especially in the current financial climate. People won't want to change unless it's the right time for them - money or no money.

    We have a huge public health problem which needs tackling - but this isn't the way to do it in my opinion.


  7. I personally think the monetary incentive would work wonders but not in the form of pure cash - in the form of food vouchers. Making sure people make a healthy diet choice will ensure they will lose weight, and by giving them vouchers will ensure they do not spend the money on unhealthy produce (and also ensures they aren't barred from healthy choices by their income). If my GP said "for every Xpound you lose, you will recieve £5 of healthy food vouchers" I think I'd be persuaded to lose more weight. By only allowing the 'reward' to be spent on fruit or vegetables it ensures that the healthy behaviour will continue.


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