Pfizer's behavioral science secret to helping smokers quit

The Challenge

Peer Insight is an innovation firm located in Washington, DC, comprised of a team of brilliant problem solvers. They partner with change-makers to create “net-new” growth, that is, from products and services beyond a company’s existing portfolio.

One of those change-makers is Lauri Kien Kotcher, who, in the mid-2000s, was the SVP of Marketing for Pfizer Consumer Health. Lauri had a weak product in her portfolio: Nicorette. The patch-or-gum nicotine replacement therapy was experiencing weak sales and weak customer outcomes, and she was at a crossroads: she could either kill the product or…could she turn it into part of a successful smoking cessation service?

she could either kill the product or…could she turn it into part of a successful smoking cessation service?

She shared this idea with Peer Insight, and they gave the project the codename, “Pavlov.” The Peer Insight team helped Pfizer conduct a year-long market experiment to hypothesize, test, and iterate on a “quit service” that incorporated Nicorette. A key part of their process was to collect SAY and DO data to understand the root of the problem (the WHY).

Smokers Have Intentions to Quit

Smoking cessation research had shown that the average smoker made at least five separate attempts to quit the habit. Despite this pattern of failure, the Pavlov team discovered that many younger (age twenty-five to thirty-five) smokers were convinced that they weren’t addicted to nicotine. Rather, their smoking habit was “a lifestyle choice.” And they said that someday soon, they would make a different choice.

The DO data suggested something fairly different. Smokers would plan for months and months in advance of their quit attempt, anticipating a time when they would be able to mass their energy, as if for a big fight. (The time window after the Super Bowl and before finals was popular with smokers in their twenties.)

Some would keep their attempt to quit a secret, refusing to inform any of their friends of their plans. Others would pull all the stops, enrolling friends and co-workers, starting an exercise program, etc.

The Disconnect Between the SAY and the DO Data

Tim and his team realized that the SAY and the DO data was not giving his team the whole picture, so they began decoding the WHY data. With each failure, the time interval between quit attempts became longer. What was driving the smoker’s reluctance to try again?

What was driving the smoker’s reluctance to try again?

The Fear of Failure

One of the key challenges they identified was the fear of failure, while another was the lack of near-term relevance was also an issue. These smokers knew the long-term hazards of smoking, but they didn’t feel the consequences today, and they wouldn’t until the distant future.

These smokers had frequently been chastened by doctors, family members, and others telling them how harmful smoking was for their health. Showing an image of what their lungs would look like in thirty years didn’t have much of an effect. Images of medical professionals in lab coats evoked eye rolls.

One of the key challenges they identified was the fear of failure

How could they address this paradox of what they SAY (“I’m not addicted…those risks are a long way off…”) and what they DO (planning for months, saving their energy, etc.)? What seemed to lurk just behind the curtain was a deep fear they would fail yet again.

What if, instead of, ‘Leave me alone, I can do this,’ what they were really feeling was, ‘OMG, I’m afraid I can’t do this, and no one can help me?’ Did these people feel doomed to a life sentence of smoking?

The “Lurking Fear”

Based on their “Lurking Fear” hypothesis, the team brainstormed a concept based on reframing the service as a gym membership instead of a medical intervention. What if they provided the smoker with a coach and teammates who would encourage them instead of scolding them? Perhaps what they needed wasn’t a different form of reprimand, but an ally.

…reframing the service as a gym membership instead of a medical intervention

Someone who would be by their side, encouraging them along the path, and helping mitigate their fear of failure. This came in the form of a “Quit Coach.”

A Friend in the Quest to Quit

As part of this program, smokers would have access to a live one-on-one coach who would help guide them through their journey, and a small cohort of “quit buddies” who were connected via text message. They tested this approach with thirty-five volunteers, and the outcomes were five times more successful than the Nicorette-only baseline.

The Creation of Active Stop

This evolved into the solution they took to market, branded as ActiveStop. It provides a personalized quit coach and an online portal that gives smokers access to resources and the ability to create a customized plan for quitting.

Most importantly, though, was the ingenious incorporation of a soft commitment device. By making an explicit commitment to their Quit Coach, smokers increased the likelihood that they would follow through on their intention.

This commitment device approach worked. Built from the underlying WHY, it not only provided a win for smokers wanting to quit, but also for Lori Kien Kitcher and the Pfizer team in making their Nicorette product relevant again. It became Pfizer’s first revenue-generating service, and this treatment option is still alive and well today.

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