Rational (and quasi-rational) decision-makers respond to incentives. If the costs of doing something go up, they tend to do less of it. If the costs go down, they tend to do more. And the reverse is true of benefits. Changing the costs and/or benefits of an activity therefore should be expected to change behaviour.
Does that logic extend as far as behaviours involving addiction and self-control problems? Consider alcohol consumption. Can heavy drinkers be incentivised to remain sober, at least temporarily, by increasing the costs of drinking, or increasing the benefits of not drinking? That is essentially the question addressed in this 2019 article by Frank Schilbach (MIT), published in the prestigious journal American Economic Review (open access).
Schilbach conducted a field experiment over three weeks with 229 cycle-rickshaw drivers in Chennai, India. In the experiment, the drivers were randomly split into three groups. The first group received a financial incentive to remain sober (the 'Incentive group'). The second group were paid an unconditional payment of similar magnitude (the 'Control group'). The third group got to choose between the sobriety incentives and the unconditional payment (the 'Choice group'). To receive their payment, the study participants had to report to the study office and submit to a breathalyser test. Schilbach was really interested in the effect of alcohol consumption on savings behaviour, so each research participant was offered the opportunity to save money at the study office each day. He was also interested in the effects on labour market participation and earnings, which were determined using surveys of the research participants.
The results reveal a number of important things about rational behaviour among heavy drinkers. First, the group that was given the choice between sobriety incentives and an unconditional payment demonstrated a strong demand for sobriety:
One-third to one-half of study participants chose sobriety incentives over unconditional payments, even when this choice entailed a potential or certain reduction in study payments...
One-third of the participants in the 'choice group' were willing to give up as much as 30 percent of their study earnings in order to be given the sobriety incentives. Schilbach isn't able to definitively determine why there was such high demand for sobriety, but he does note that:
First, study participants had significant experience with alcohol consumption and the potentially resulting self-control problems. The average study participant had been drinking alcohol for over a decade and many of them had been drinking (almost) daily...
Second, individuals perceived the costs associated with their drinking as significant. Many individuals expressed a strong desire to reduce their drinking in surveys and informal conversations. These men had spent substantial income shares on daily alcohol consumption for many years before participating in the study. Compared to these expenses, the forgone study payments due to the commitment choices may have appeared relatively small to individuals, especially if they implied a positive (perceived) chance of reducing subsequent alcohol consumption in the longer run.
So, the research participants may have perceived the experimental setting, and the money on offer, as a way to commit themselves to sobriety, at least for the period of the study. Did the incentives work, though? Schilbach finds that they did:
In the pre-incentive period, about one-half of the individuals in each of the three groups visited the study office sober. This fraction gradually declined in the Control Group to about 35 percent by the end of the study... In contrast, with the start of the incentivized period, sobriety in the Incentive and Choice Groups increased by about 10 to 15 percentage points. Subsequent sobriety at the study office also declined in these two groups, but the difference to the Control Group remained roughly constant.
Regression models confirm that the Incentive and Choice groups were approximately 13 percentage points more likely to visit the study office sober than the Control group, and the average breath alcohol content (BAC) was 2 to 3 percent lower for the Incentive and Choice groups than for the Control group (conditional on visiting the study office). Schilbach notes that the effect was largest on daytime drinking and not overall alcohol consumption, suggesting that many study participants simply shifted their drinking to later in the day (after visiting the study office).
Did sobriety affect labour market outcomes? Schilbach finds small and statistically insignificant effects on labour supply, hours worked, and earnings. As for savings, Schilbach found that the intervention increased savings, with the Incentive and Choice groups saving about 50 percent more than the Control group over the study period. Schilbach interprets this as showing that:
...increasing sobriety reduced self-control problems in savings decisions. An alternative interpretation could be that alcohol is a key temptation good for this population such that reducing alcohol consumption mitigates the need for commitment savings. However, given that the intervention only moderately reduced overall alcohol consumption and expenditures, this channel is unlikely.
My takeaway from this paper is that many heavy drinkers recognised their own self-control problems and were willing to give up some income for a commitment device that would help them remain sober. The commitment device increased the costs of drinking (or, equivalently, increased the benefits of not drinking). So, the drinkers who chose the sobriety incentives were acting rationally in response to a change in incentives. The research participants who shifted their drinking to later in the day were also acting quite rationally. By shifting their drinking to later in the day, they could receive the benefits of the sobriety incentive, while continuing to drink (albeit later in the day). In other words, the incentive changed behaviour, just not necessarily in the way it was intended to.
So, if you wanted to roll out a broader intervention based on changing incentives for heavy drinking, it might be better to measure sobriety at multiple times of the day. However, in this context even the later drinking may have reduced some of the potential alcohol-related harm, since there may have been fewer drunk-driving cycle-rickshaw drivers on the streets of Chennai (although, to be fair, the study doesn't actually show that there was less drink-driving).
It would be interesting to know how much of these study results are context-dependent, and whether a similar intervention would work elsewhere. If you tried to incentivise heavy drinkers in a high-income country to reduce their consumption, would they respond in a similar way? That question will have to wait for future research.
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