Shopping vouchers help new mothers stay smoke-free, Stirling study shows

Offering shopping vouchers to mothers who stop smoking during pregnancy doubles their chances of remaining smoke-free several years later, new research has found.

The study, led by the University of Stirling in collaboration with the Universities of Edinburgh and Nottingham, is the first to show long-term benefits of offering financial incentives to encourage women who have stopped smoking in pregnancy to avoid returning to smoking.

Statistics show as many as three-quarters of women who stop smoking in pregnancy are likely to return to smoking within six months of giving birth, increasing their risks and their children’s risks of smoking-related illness.

Mothers who participated in the study received up to £240 worth of vouchers if tests confirmed they had not started smoking again in the first year after the birth of their child. A chosen supporter also received £60 if the mother remained smoke-free.

The vouchers were only offered if carbon monoxide monitoring of the mother’s breath confirmed that they were not smoking. They were assessed on multiple occasions during the baby’s first year.

The new study found the abstinence rate after three to four years increased from 7% under usual care to 16% with the 12-month incentive programme.

Long-term benefit

Professor Michael Ussher, of the University of Stirling’s Institute for Social Marketing and Health (ISMH), who led the study, said: “We found that offering up to £240 of vouchers for the woman and £60 for her supporter during the baby’s first year more than doubled the number staying smoke-free several years later when compared with those receiving no vouchers. 

“These findings are the first evidence to show that offering vouchers has a long-term benefit for staying smoke-free, reducing these women’s chances of developing smoking related illness.”

The Financial Incentives for Prevention of Postpartum return to Smoking (FIPPS) study invited 462 women in Greater Manchester who had stopped smoking during pregnancy and were at the end of their pregnancy, or had recently given birth, to take part in the study. Participants were randomly assigned to receive vouchers or no vouchers.

One third of participants received up to £240 of vouchers for themselves and an additional £60 of vouchers for a supporter over 12 months; one third received £120 of vouchers for themselves and £60 for a supporter over three months; and the final third of women received usual postnatal care. 

At the three to four-year follow-up point, researchers found offering up to £300 of incentives over 12 months postpartum achieved validated abstinence rates of 16%, compared with rates of 12% when offering £120 over 3 months, and 7% for usual care.

The study Financial incentives for maintaining postpartum smoking abstinence: 3 - 4-year follow-up of the Financial Incentives for Prevention of Postpartum return to Smoking (FIPPS) randomized controlled trial was published in the journal Addiction. It was funded by Greater Manchester Combined Authority.

Researchers have recommended further trials to confirm whether incentives are effective in other populations of pregnant and postpartum women.