Pregnant women are more likely to quit smoking if financial rewards are offered as part of a treatment plan, according to new research carried out by academics including the University of Stirling’s Professor Linda Bauld.
Smoking in pregnancy is a leading preventable cause of maternal and neonatal illness and death in developed countries. In the UK alone, around 5000 foetuses and babies die from mothers smoking during pregnancy each year. Current interventions are not particularly effective.
Smoking in pregnancy costs the NHS up to £64 million for problems in mothers and up to £23.5 million for infants.
Professor Bauld, along with colleagues including Professor David Tappin of the University of Glasgow, assessed whether financial incentives in the form of shopping vouchers can motivate pregnant women to quit smoking. In total, 612 pregnant smokers were randomly assigned to one of two groups.
Half were assigned to a group offered up to £400 of financial incentives if they engaged with ‘'usual care’ smoking cessation services and/or quit smoking during pregnancy. The other half were offered ‘usual care’ smoking cessation services that included a face-to-face appointment with a smoking cessation adviser, four follow-up support calls and free nicotine replacement therapy for 10 weeks.
Women who were offered shopping vouchers were significantly more likely to quit smoking than those in the control group. Overall, 69 women quit from the test group and 26 from the control group - 23% and 9% respectively. This was confirmed by testing for cotinine (a nicotine breakdown product) in urine or saliva.
After 12 months, 15% of women who were offered financial incentives remained off cigarettes compared to only 4% in the control group. No harmful effects were reported from the test group and there was little evidence of false information being provided in order to receive incentive payments.
The report, published by the British Medical Journal, says: "This study provides substantial evidence of a very promising and potentially cost-effective new intervention to add to present health service support. The findings can serve as the basis for future research to include other UK centres and other health care systems."
The authors also add that there is potential for financial incentives to “sit with vaccines as an important preventative healthcare intervention strategy.” Stopping mothers from smoking has a ripple effect on the health of their children, and providing income to poor families can help to reduce inequalities, they explain.
This study was funded by the Chief Scientist Office, Scottish Government, the Glasgow Centre for Population Health and the Education and Research Endowment Fund of the Director of Public Health, NHS Greater Glasgow and Clyde. Additional support was received from the Yorkhill Children's Charity and the Royal Samaritan Endowment Fund.
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- Background information
The research paper, entitled ‘Financial incentives for smoking cessation in pregnancy: a randomised controlled trial’, is available at www.bmj.com/cgi/doi/10.1136/bmj.h134.
Professor Linda Bauld, UK Centre for Tobacco and Alcohol Studies and Institute for Social Marketing, School of Health Sciences, University of Stirling, Scotland.
Tel: +44 (0)7714 213 372 / +44 (0)1786 467347 (personal assistant)