The National Institute for Health and Clinical Excellence (NICE) is to ask members of the public for their views on the use of incentive systems as a way of motivating people to change unhealthy lifestyles.

The move follows a 62.5% vote in favour of such incentive schemes at a recent meeting of NICE’s independent advisory Citizens Council.

While incentive schemes are not commonly used in the UK to improve public health, the Council meeting heard of examples of localised pilot schemes, which included: - an initiative to encourage pregnant women to stop smoking by offering supermarket vouchers; - people receiving cash for losing agreed amounts of weight; and - children being rewarded with toys in exchange for eating more fruit and vegetables.

While the majority of Council members voted in favour of incentive schemes, they said that this was dependent on certain conditions being in place, for example: - incentives should never be exchangeable for tobacco or alcohol;  - they should only offered to people who are committed to changing their health behaviours; - cash incentives should be only offered as a last resort; - the progress of participants is monitored throughout; and - the results of the schemes are analysed so that more can be learnt about their effectiveness.

They also agreed that incentive schemes are likely to work best when they are targeted and used as part of wider programme of support.

Those who voted against the use of incentives (37.5%) did so for reasons including uncertainty over the long-term benefits of such initiatives due to lack of evidence, their potential for abuse, their cost and because of their perceived unfairness towards people who are able to live healthy lives without them.

Commenting on the vote, NICE chairman professor Sir Michael Rawlins said: “we clearly face several public health challenges in today’s society, some more obvious than others, and we must seek to improve these in ways that are likely to achieve the best health outcomes for those affected. The majority of the Council has voted in favour of the use of incentives under certain circumstances, but this clearly remains a divisive issue. We are now very keen to hear what the general public thinks about their conclusions.”

The Citizens Council report is now available on NICE’s website and the Institute is asking for comments by 5.00 pm on November 26.