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What would make a smoker more likely to quit, a big reward for succeeding or a little penalty for failing? That is what researchers wanted to know when they assigned a large group of CVS employees, their relatives and friends to different smoking cessation programs.
想让吸烟者戒烟，是对戒烟成功大加奖励还是对戒烟失败小施惩戒更加有效？为了搞清楚这个问题，研究人员让CVS药店的一大群员工及其亲朋好友接受了不同的戒烟方案。
The answer offered a surprising insight into human behavior. Many more people agreed to sign up for the reward program, but once they were in it, only a small share actually quit smoking. A far smaller number agreed to risk the penalty, but those who did were twice as likely to quit.
他们得到的答案展示了人类行为中令人惊讶的一面。有很多人都愿意参加奖励方案，但在加入之后，真正戒了烟的人寥寥无几。而在同意冒险尝试惩罚方案的那一小部分人当中，成功戒烟的可能性却是前者的两倍。
The trial, which was described in The New England Journal of Medicine on Wednesday, was the largest yet to test whether offering people financial incentives could lead to better health. It used theories about human decision making that have been developed in psychology and economics departments over several decades and put them into practice with more than 2,500 people who either worked at CVS Caremark, the country's largest drugstore chain by sales, or were friends or relatives of those employees.
这项试验于5月13日发表在《新英格兰医学杂志》上，它是迄今为止规模最大的一项以测试经济奖励能否改善人们健康为目的的研究。该试验采用了心理学和经济学部门在近几十年来建立起来的人类决策理论，并将其应用于美国最大的连锁药店CVS Caremark公司的员工及其朋友或亲戚。合计参与人数超过了2500人。
Researchers found that offering incentives was far more effective in getting people to stop smoking than the traditional approach of giving free smoking cessation help, such as counseling or nicotine replacement therapy like gum, medication or patches. But they also found that requiring a $150 deposit that would be lost if the person failed to stay off cigarettes for six months nearly doubled the chances of success.
研究人员发现，与传统的戒烟方法，即通过各种方式免费帮人戒烟（如提供咨询，使用口香糖、药物或贴片等尼古丁替代疗法）相比，提供奖励的效果要好得多。但他们也发现，如果要求参与者交150美元保证金，且告知他们在6个月内无法戒烟就拿不回保证金，戒烟的成功率几乎可以翻一番。
“Adding a bit of a stick was much better than a pure carrot,” said Dr. Scott Halpern, deputy director of the Center for Health Incentives and Behavioral Economics at the University of Pennsylvania School of Medicine, who led the study.
该研究的负责人，宾夕法尼亚大学医学院健康激励和行为经济学研究中心副主任斯科特·哈尔彭博士说：“胡萝卜加一点大棒的效果比纯用胡萝卜更好。”
The finding is likely to get the attention of large companies as they sort out what types of benefits to offer employees in an era of rising health care costs. Most large employers, which bear much of those costs, now offer incentives for health-promoting behavior in the form of employee wellness programs, but until now, they have had little evidence of what types of programs actually work to guide them.
在这个医疗费用不断上涨的时代，上述发现很可能会引起那些正在考虑该为自己的员工提供何种福利待遇的大公司的关注。大多数大型用人单位承担着员工医疗费用的绝大部分，他们现在多以员工保健计划的形式来激励促进健康的行为，但到目前为止，还没有多少证据能证实哪种方案可以真正有效地指导他们。
And even a small decline could have a big health effect. Smoking is the largest cause of preventable death in the United States. Diseases linked to it kill more than 480,000 Americans a year.
在美国，吸烟是可预防性死亡的首要原因。每年因吸烟相关疾病致死的美国人超过48万人。因此，哪怕是吸烟率的小小降低也将带来巨大的健康效应。
