Research shows that smokers are more likely to give up their habit and stay smoke-free if they are rewarded for doing so
Research shows that smokers are more likely to give up their habit and stay smoke-free if they are rewarded for doing so.
The incentives are especially effective among pregnant women, who are twice as likely to quit when financial incentives are offered.
Health campaigners say the ‘clear evidence’ should lead to the widespread rollout of reward schemes for pregnant smokers.
They can take the form of cash payments, vouchers or the return of money deposited by the participants.
Such programs are conducted in workplaces and clinics and sometimes as community programs.
Smoking during pregnancy increases the risk of miscarriage and stillbirth and increases the chance that the baby will be underweight.
Research led by the University of East Anglia analyzed 48 studies, involving 21,900 participants, testing different reward systems to help smokers quit.
For every 100 people who received financial incentives, 10 people were likely to successfully quit smoking after six months or more, compared to seven in 100 people who did not receive financial incentives.
The incentives are especially effective among pregnant women, who are twice as likely to quit when financial incentives are offered (stock image)
Smoking during pregnancy increases the risk of miscarriage and stillbirth and increases the chance that the baby will be born underweight (stock image)
The success rates continued after the incentives ended.
Women who were pregnant and received a reward were much more likely to quit smoking than women in the control groups, both at the end of pregnancy and after the baby was born (13 studies, 3,942 people).
For every 100 pregnant women who received financial incentives, thirteen of them were likely to successfully quit smoking after six months or more, compared with six in 100 who did not receive financial incentives.
Studies varied in the total amounts of rewards paid and there was no noticeable difference between studies that paid smaller amounts (less than $100) compared to studies that paid larger amounts (more than $700).
However, the researchers noted that it is difficult to make a fair comparison in this situation because money has different degrees of importance in different cultures, and the studies they looked at came from many different countries.
This made it difficult to directly compare the results of the studies.
Lead author Professor Caitlin Notley, from UEA’s Norwich Medical School, said: ‘Smoking is the leading preventable cause of ill health and premature death worldwide and quitting smoking is crucial to helping people live longer in good health.
‘We wanted to find out whether giving people rewards helps them to quit smoking in the long term.
‘We are now confident that incentives will help people, and pregnant people, to quit smoking better than not offering incentives.
“The evidence also shows that the effectiveness of incentives continues even after the rewards stop.”
The government is currently implementing a national scheme to provide financial incentives to all pregnant women who smoke, in addition to support to quit smoking.
However, funding for this program will run out in March 2025, which activists say could undermine progress in reducing maternal smoking rates.
The Smoking in Pregnancy Challenge Group – a coalition that includes the Royal College of Midwives and the Royal College of Obstetricians and Gynecologists – is calling on the government to extend the scheme for the duration of this parliament.
Professor Linda Bauld, co-author of the review and co-chair of the SPCG, said: ‘Smoking during pregnancy is one of the leading causes of poor birth outcomes, including stillbirth and miscarriage.
‘These findings show that financial incentives during pregnancy can more than double the chances of quitting smoking and that incentives are also effective in preventing women from returning to smoking postnatally.
‘This evidence supports the case for continued investment in the existing national financial incentive program for pregnant women in England.’
Jamie Hartmann-Boyce, another co-author from the University of Massachusetts Amherst, said: ‘People are more cautious during pregnancy about using many of the pharmacological interventions approved for smoking cessation.
Women who were pregnant and received a reward were much more likely to quit smoking than women in the control groups, both at the end of pregnancy and after the baby was born (stock image)
The government is currently rolling out a national scheme to offer all pregnant women who smoke financial incentives as well as support to quit smoking (stock image)
‘That’s why we focus on ways we can help pregnant people quit smoking.
‘There is a lot of evidence to suggest that this intervention acts on the psychological reward systems in the brain, which we know are strongly involved in nicotine addiction.
“So it’s not like these people could have quit in the first place and then got paid and decided to do so.
‘Many people in these studies have tried to quit many times, they really wanted to quit and couldn’t, and this helped them.’
Dr. Clea Harmer, chief executive of baby charity Sands and co-chair of the SPCG, said: ‘The evidence is clear that financial incentives are highly effective in helping pregnant women quit smoking and stay smoke-free.
“We urge the government to expand the national stimulus program to ensure women and families get the support they need to have a smoke-free pregnancy and a healthy baby.”
The findings of the study have been published by the international medical review organization Cochrane Review.