University of Edinburgh: Vouchers help to quit smoking in pregnancy

The combination of offering £400 in vouchers for well-known shops alongside regular services to help pregnant women quit smoking proved more effective than just the services on their own.

In a randomised-controlled trial with 1,000 pregnant women who were smokers, everyone received standard smoking cessation services but one half were offered the voucher incentive scheme as well.

Only 12 per cent of pregnant women from the group who did not receive the voucher stopped smoking by the end of their pregnancy, compared with 27 per cent of women from the voucher incentive group.

Smoking harms
Maternal smoking is linked with significant ill health and death among women and their children, including 7 per cent of childhood hospital admissions for respiratory infection, 20 per cent of infant deaths and 30 per cent of babies born underweight.

Research has shown that women who permanently quit smoking during pregnancy will go on to have a near normal lifespan, whereas women who continue to smoke in pregnancy and beyond are likely to lose up to 10 years of life.

Smoking status
The study took place at seven different sites across the UK – in Scotland, England and Northern Ireland – and confirmed smoking status through nicotine saliva testing.

The participants were tested for smoking status at several points in their pregnancy including just before their due date- between week 34 and week 38 of pregnancy. Most of the pregnant women who quit from both groups relapsed after their baby was born.

Research is ongoing to extend support – including with financial voucher incentives – for 12 months after the baby is born, to see if mothers remain non-smokers.

The study was carried out by teams from Universities of Edinburgh, Glasgow, Stirling and York and Queen’s University of Belfast and the findings published in The BMJ.

Our study shows just how effective voucher incentives are as a quitting aid when added to stop smoking service support. Most women who smoke in pregnancy in the UK are from lower income groups, who will be most affected by the cost of living crisis, and these vouchers will have helped them both make a quit attempt and stay smoke-free through pregnancy. This kind of intervention is about prevention, spending up front to avoid much more serious and costly health problems for the baby and the mum if she continues to smoke.

Professor Linda Bauld
Bruce and John Usher Professor of Public Health and joint principal investigator for the study from the University of Edinburgh
The work was funded by Cancer Research UK, the Scottish Government Chief Scientist Office, HSC Public Health Agency Northern Ireland, HSC R&D Division NI, Chest Heart and Stroke Northern Ireland, The Scottish Cot Death Trust and The Lullaby Trust.