£400 ‘bribes’ for pregnant women to quit smoking

Smokers were offered vouchers. Picture: TSPL
Smokers were offered vouchers. Picture: TSPL
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SCOTTISH mothers who manage to quit smoking during pregnancy have been rewarded with £400 in a publicly funded scheme that could be rolled out across the country.

One in five pregnant smokers recruited in NHS Greater Glasgow and Clyde were able to quit after being rewarded with financial incentives.

Six hundred women took part in the pilot scheme which cost £750,000 and was co-funded by the NHS and the Scottish Government, along with research grants.

The team behind the experiment have now applied for further funding to test the intervention strategy in NHS Lanarkshire and called on the Scottish Government to introduce the programme across the country.

But critics have labelled the plans “dubious”, claiming it is “essentially bribing” women to change unhealthy behaviour.

One in five pregnant women in Scotland are smokers, and smoking ten or more cigarettes per day during pregnancy has been proven to double the risk of stillbirth.

The risk of cot death increases seven-fold when the mother smokes more than 20 a day.

During the trial, carried out on behalf of the UK Centre for Tobacco Control, participants were rewarded with £50 in vouchers, which can be used in most high street shops, after booking their first face-to-face appointment with an NHS smoking cessation adviser and setting a date to quit.

If they remained smoke-free for four weeks, they received a further £50 in vouchers, rising to £100 at three months and a final £200 if they reached the end of their pregnancy.

The women were rigorously tested during the process using a carbon monoxide breath test, urine and saliva samples as well as blood tests to ensure they were not cheating.

At the end of the trial, 21 per cent of the women who had been rewarded with financial incentives were able to quit smoking, compared with just 9 per cent of women who received the standard NHS cessation support.


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A survey also carried out by the team of more than 1,000 members of the public found men were more supportive than women when it came to dishing out financial incentives to pregnant smokers.

The head of the health team, Professor Linda Bauld of Stirling University, said they now hope to test the initiative in NHS Lanarkshire.

She added: “Policymakers may worry about the costs of the intervention, but in the long run it would make massive healthcare savings if we can get women to stop smoking in their pregnancies.

“Even if you paid the women double it would be cost-effective in the long run, saving the NHS money. It would be putting in the money today to benefit tomorrow.”

Dr Jean Turner, executive director of the Scotland Patients Association, supported the scheme. “This is excellent research that has proved there are enormous benefits to be gained,” she said.

“There will be a lot of opposition, but the long-term health benefits to the mother and unborn child, alongside longer-term NHS savings, prove it would be a very good move.”

However Eben Wilson, director of TaxpayerScotland, called the initiative “a statistically irresponsible use of taxpayers’ money”.

He said: “The problem is there is unlikely to be any way to measure efficacy or outcomes properly. The ethics of essentially bribing people to change behaviour on the basis of paying them to be responsible about their own health seem dubious at best – free money is not the answer to bad lifestyle choices.”

A Scottish Government health spokesman said any application to fund new research would be “considered in due course”.

He added: “This is a research project that would need detailed evaluation before any further action is taken.

“Giving up smoking is the best thing a smoker can do to improve their health.”


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