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According to a recent study, offering concrete compensation to pregnant women to encourage them to quit smoking would have a real beneficial effect throughout pregnancy. A measure that is more effective than the prevention campaigns put in place.
Offering a reward to pregnant women and smokers would help them more easily to quit smoking, at least during their pregnancy. This is the formal conclusion of a Scottish study revealed on October 19 and published in the scientific journal British Medical Journal.
The offer of up to £400 in vouchers on top of regular support has proven to be very effective. If the initiative may surprise or seem questionable, in fact, the compensation more than doubled the proportion of women who were still not smoking at the end of pregnancy in the sample studied. What to put this in parallel with the costs spent to fight against fetal smoking.
455 euros to set a quit date and stick to it
To reach these conclusions, the research was based on the study of 941 pregnant women (average age of 28 years) recruited from seven smoking cessation services in Scotland, Northern Ireland and England between January 2018 and April 2020. Participants reported smoking during their first maternity visit, when they were, on average, 11 weeks pregnant. The participants were then divided into two groups:
- An intervention group and a control group. The control group was offered usual support to quit smoking, (advice, free therapy, nicotine replacement…);
- The intervention group was offered the usual support with a bonus of up to £400 (€455) in vouchers if the women set a quit date and remained abstinent throughout their pregnancy.
This abstinence was verified by a carbon monoxide breath test. A final voucher was given to those who declared that they were still smoke-free at the end of pregnancy (between 34 and 38 weeks of gestation), verified by a saliva test.
Twice as many stops at the end of pregnancy!
Ultimately, more women in the incentive group (71%) than in the control group (64%) engaged with smoking cessation services and set a quit date. Saliva tests confirmed that 126 (27%) women in the intervention group had quit smoking late in pregnancy, compared to 58 (12%) controls.
With one caveat, however: abstinence rates measured six months after delivery were low in both groups (6% in the intervention group versus 4% in the controls), suggesting that most women who quit smoking relapsed shortly after the birth of their baby.
The priority today: find an effective motivation
The results of this study show that rewarding pregnant women in this way more than doubled the proportion who were still smoke-free at the end of pregnancy., compared to those who only received regular support. And while the money involved may come as a surprise to many, the study claims that in the longer term, this method could save costs for the NHS (National Health Service).
“Financial incentives for prolonged smoking abstinence during pregnancy are among the most cost-effective health care interventions and a key opportunity to reduce health inequities in early life” say the researchers in a linked editorial.
“If paying pregnant women to quit smoking works, morality doesn’t matter”
A study that echoes a French experiment carried out in 2016 in 16 French maternity wards on the financial incentive for pregnant women to quit smoking, which then shocked many people. Contacted about the benefits of this method, Dr. Berlin, a doctor specializing in addiction and behind this study, expressed his opinion in the lines of Doctissimo:
“Nothing exists in France to help highly dependent pregnant women to quit smoking. Women know very well that they should not smoke while expecting a child, but being pregnant is not sufficient motivation for some. There are markers biological substances independent of the will, often present young in the life of his wives, which indicate that the physiological influence of tobacco is very high. If paying pregnant women to stop smoking works, morality doesn’t matter.”
As a reminder, smoking during pregnancy is associated with a series of problems, including an increased risk of death at birth, sudden infant death syndrome, asthma and obesity in children.