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Financial incentives could prompt smoking cessation in pregnant women

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Pregnant women are more likely to quit smoking if financial rewards are offered as part of a treatment plan, according to new research.

A group of 612 pregnant smokers were randomly assigned to one of two groups by a University of Glasgow and University of Stirling study.

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.

“This study provides substantial evidence of a very promising and potentially cost-effective new intervention”

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 no suggestion of “gaming”.

Smoking in pregnancy is a leading preventable cause of maternal and neonatal illness and death in developed countries. In the UK alone, around 5,000 foetuses and babies die from mothers smoking during pregnancy each year. Current interventions are not particularly effective.

Smoking in pregnancy can cost the NHS up to £64 million for problems in mothers and up to £23.5 million for infants.

“This study provides substantial evidence of a very promising and potentially cost-effective new intervention to add to present health service support,” write the authors. “The findings can serve as the basis for future research to include other UK centres and other healthcare 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.

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Readers' comments (2)

  • This is laughable!!! You wont stop smoking to protect the welfare of your baby and better your own helath but get given a few hundred pounds to spend are you will have the whole country signing up!! Total joke!!!!

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  • Read the BMJ paper.

    The response to this research has been framed in middle class shrieks of outrage and the demonisation of pregnant smokers. Usually from those who have no understanding of young pregnant mothers in areas of multiple deprivation. From this pilot study there is clear evidence that this is an effective intervention. We might not like the idea and there is certainly a case for further multi-centre trials (which is what the team have recommended) to look at mechanisms, generalisability, etc. However, to disregard an intervention which has the potential to dramatically improve outcomes for unborn children just because it offends our sensibilities, would be the total joke here.

    Childhood cancers caused by X-raying pregnant women, was comprehensively proved a full 25 years before clinicians stopped the practice. In spite of overwhelming proof, they simply did not like the idea that what they thought should happen, was actually causing damage.






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