Financial incentives reduce smoking and improve wellbeing in pregnant women

Limited data is available on the effectiveness of financial rewards to aid smoking cessation and abstinence in women who are pregnant. In the UK a key milestone is achieving abstinence at four weeks following an initial meeting with midwife and support from stop smoking services. The aim of this study was to evaluate the effects of a generous scheme which provides incentives in a staged schedule, amounting to a total reward of 145 for setting a quit date and staying abstinent for 4 weeks. This pilot feasibility study recruited successfully to target (n = 50 women), focusing on those from disadvantaged backgrounds. Baseline and post intervention data were collected, plus abstinence data at delivery was provided by midwifery services. Abstinence was assessed using biomarkers. Ethical approval was granted. Just less than half the women (44%) managed to remain abstinent for the course of the intervention. At time of delivery, 22% of women were abstinent which is considerably higher than what is achieved by treatment as usual (6%). The findings compare avourably with a bigger study which used larger incentives using a different schedule (maximum reward 400). Wellbeing was assessed and was low at baseline, but improved over the duration of the intervention (p = 0.03). This suggests that the schedule tested in this study has potential for reducing rates of smoking in a highly vulnerable group, and helps to improve wellbeing. Alarger study using this schedule and including a control group, and possible incorporating alternative rewards schedules needs to be considered.