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Financial incentives reduce smoking in pregnancy

Shopping vouchers can be used to encourage pregnant women not to smoke, claim researchers.

Published in the British Medical Journal (BMJ) today, a trial involving 600 women from Glasgow highlighted that financial incentives had a beneficial impact upon smoking rates in mothers-to-be.

More than 20% of the women who were offered shopping vouchers quit smoking during their pregnancy in comparison to the 9% who quit with NHS support alone.

Women taking part in the trial had regular breath tests and provided saliva, blood and urine samples to check that they were not smoking.

The financial incentive group received that standard support - as well as £50 in their first appointment, £50 if a breath test later suggested they had stopped smoking, and then a further £100 after another 12 weeks.

The final £200 voucher was given if another breath test at 34-38 weeks in pregnancy confirmed there was no carbon monoxide exhaled.

After a year, 15% of women who received the vouchers had managed to stay off cigarettes, compared with 4% in the control group.

The researchers from Glasgow and Stirling universities say providing the vouchers is cost-effective for the NHS, because smoking in pregnancy raises the risk of miscarriage and stillbirth.

The authors say in the BMJ: "This study provides substantial evidence of a promising and potentially cost-effective new intervention to add to health service support.

"Smoking during pregnancy remains a major health problem, resulting in the deaths of an estimated 5,000 foetuses and babies each year in the UK.

"It is responsible for tens of millions of pounds in extra healthcare spending.

"Receipt of financial incentives can contribute to needed household income in advance of the arrival of a baby in low-income households.

"Financial incentives to stop smoking could reach smokers who become pregnant before cigarettes have affected their health."

Janet Fyle of the Royal College of Midwives said education could encourage people to make healthy choices.

"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 wellbeing of individuals."