Pregnant smokers quit habit if paid, says report

http://www.theguardian.com/society/2015/jan/28/pregnant-smokers-quit-if-paid-report

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Pregnant women who smoke are more likely to give up their habit if offered a financial incentive, according to a study published in the British Medical Journal.

Researchers at the universities of Glasgow and Stirling concluded that offering pregnant smokers up to £400-worth of shopping vouchers was “potentially cost-effective” in comparison with an estimated annual cost to the NHS of £64m for treating smoking-related problems in mothers and £23.5m for babies up to the age of 12 months.

The study contrasted a group of women who were offered the standard NHS smoking cessation advice with those who were also offered an initial £50 online shopping voucher after setting a date to quit. This group was then given further vouchers of £50, £100 and £200 if they managed to abstain from smoking for up to 38 weeks after the set date.

Overall, 23% of the pregnant smokers who were offered vouchers stopped smoking compared with 9% of the control group. After a year, 15% of those who received the vouchers remained non-smokers, compared with 4% in the other group. The results were verified using a breath test.

While the report’s authors acknowledged that there could be ethical issues in offering financial incentives to make significant behavioural changes, lead author Prof David Tappin, said: “Many of these mothers have inadequate housing, difficult relationships, low self-esteem and only enough income to subsist. The money, albeit in the form of vouchers, often lifts the pressure. This evidence shows that the money is the hand they need to pull them out of their addiction.”

The authors suggest that up to 5,000 miscarriages a year could be attributed to smoking during pregnancy, along with hundreds of stillbirths and infant deaths.

The Royal College of Midwives said that offering financial incentives to make healthy changes was “not ideal”. Janet Fyle, professional policy adviser, said: “Can we afford to incentivise behavioural change when the amount of potentially damaging lifestyle choices that people make could be almost limitless? What is also needed is a greater investment in prevention and in the health, educational and social care staff needed to promote the health and well-being of individuals.”

In 2013, a similar incentive scheme called Give It Up for Baby, piloted by NHS Tayside, reported that quit rates for those registering 54% at four weeks, 32% at 12 weeks and 17% at three months post-partum. It also found that pregnant smokers from more affluent areas were more successful with their attempts to stay free of cigarettes.

12.7% of women smoke during their pregnancy, according to the Health and Social Care Information Centre, though the number has been falling consistently since 2006. Pregnant women from unskilled occupations are five times more likely to smoke than professionals.