Incentives to breastfeed and quit smoking backed by the young

Incentives to breastfeed and quit smoking are backed by the young, according to a University of Stirling study

Men and women aged 44 or younger are more likely to agree with financial incentives to encourage breast feeding and smoking cessation during pregnancy compared to those aged 65 and over.

This was a key finding in a new study led by the University of Stirling which looked to assess public acceptance of financial incentives to encourage healthy lifestyle choices.

The research, which was published in BMJ Open and funded by the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme, also found that those with higher qualifications, or from non-white ethnic groups, and men, were more likely to support the incentives.

Pilot schemes in different parts of UK have offered pregnant women and new mothers a range of incentives including shopping vouchers in an effort to encourage women to adopt healthy lifestyles. Previous research has suggested these financial incentives can help to motivate women to make the best decisions for their baby’s health.

This study – which was carried out by researchers at the Universities of Stirling, Aberdeen and Central Lancashire – examined existing research to consider what made it easier for women to continue breastfeeding and stop smoking and drew up a list of the seven most promising types of incentives.

Over 1000 members of the British general public from a cross section of society were then asked for their views.

Overall, the researchers found between a third to just under a half (34%-46%) of British adults surveyed agreed with one or more types of incentives. A free breast pump was found to be the most popular.

Lead researcher, Professor Pat Hoddinott from the University of Stirling’s Nursing, Midwifery and Allied Health Professional Research Unit said: “Addressing health inequalities is a government priority so the implications of our research for efforts to reduce this inequity are important.

“Our findings are a concern because the highest levels of smoking during pregnancy and the lowest rates of breastfeeding are amongst the less educated and white British women – two of the groups showing lower levels of support for incentives.”

Co-author Dr Heather Morgan of the University of Aberdeen said: “There are many reasons why some women continue to smoke in pregnancy and do not breastfeed.  External influences – such as family and friends, work and the provision of additional support by health services – can all influence women’s ability to make these lifestyle changes.”

Dr Gill Thomson, a member of the research team from the University of Central Lancashire, said: “Evidence suggests incentives to promote behaviour change can be successful, because they can facilitate better relationships between recipients and care providers and can reassure people of their worthiness to receive help.

“However, this study tells us there are still challenges ahead in promoting the benefits to certain groups, particularly those who dislike pressure to behave in the way that the health service would like them to.”

Professor Hoddinott added: “If incentives are offered to women and they don’t work, women can feel very demoralised, particularly as every mother sets out to do the best for her baby.  Some women may need other forms of support in addition to the incentive because healthy lifestyle choices can be difficult to maintain.”

The researchers conclude that more research is needed to evaluate the proposed incentives’ reach and impact on health inequalities and ethnic groups before they are implemented across the UK.

Background information
  • The study is the largest UK survey of public attitudes to incentives aiming to change lifestyle behaviours to date
  • In the study, an incentive was defined as financial (positive or negative) and non-financial tangible incentives or rewards.  This includes free or reduced cost items that have a monetary value – like refreshments and baby products – or services like childcare or ironing.  The definition excludes intangible incentives such as supportive, motivational or persuasive relationships with professionals or peers.  Incentives may be delivered directly or indirectly at local, regional or national level by organisations. 
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