Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

Aims: Financial incentives were the single most effective intervention for smoking cessation in pregnancy in a recent Cochrane Review, but based on a few small trials in the United States using only 7-day point prevalence measures of cessation. This study estimates (a) prolonged cessation in an unselected population of English pregnant smokers who are offered financial incentives for quitting and (b) 'gaming', i.e.false reporting of smoking status to enter the scheme or gain an incentive. Design: Single-arm intervention study Setting: Antenatal clinic and community Participants: A total of 239 pregnant smokers enrolled into the financial incentive scheme, attending for maternity care at one hospital in an area of high deprivation in England over a 42-week period. Measurements: Smoking cessation at delivery and 6months postpartum, assessed using salivary cotinine; gaming assessed using urinary and salivary cotinine at enrolment, 28 and 36weeks gestation, and 2days and 6months postpartum. Findings: Thirty-nine per cent (239 of 615) of smokers were enrolled into the scheme, 60% (143 of 239) of whom made a quit attempt. Of those enrolled, 20% [48 of 239; 95% confidence interval (CI)=14.9%, 25.1%] were quit at delivery and 10% (25 of 239; 95% CI=6.2%, 13.8%) at 6months postpartum. There was no evidence that women gamed to enter the scheme, but evidence that 4% (10 of 239) of those enrolled gamed on one or more occasions to gain vouchers. Conclusions: Enrolment on an incentive scheme in an unselected English cohort of pregnant smokers was associated with prolonged cessation rates comparable to those reported in US trials. Rates of gaming were arguably insufficiently high to invalidate the use of such schemes.

Original publication

DOI

10.1111/add.12817

Type

Journal article

Journal

Addiction

Publisher

Blackwell Publishing Ltd

Publication Date

2015

Keywords

Financial incentives, Gaming, Pregnancy, Smoking, Smoking cessation, Vouchers