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Financial incentives for smoking cessation in pregnancy

BMJ 2015; 350 doi: https://doi.org/10.1136/sbmj.h1419 (Published 24 March 2015) Cite this as: BMJ 2015;350:h1419
  1. Alison Tonks, associate editor, The BMJ

Randomised controlled trial.

The paper

“Financial incentives for smoking cessation in pregnancy: randomised controlled trial” by David Tappin and colleagues (BMJ 2015;350:h134)

Abstract

Objective—To assess the efficacy of a financial incentive added to routine specialist pregnancy stop smoking services versus routine care to help pregnant smokers quit.

Design—Phase II therapeutic exploratory single centre, individually randomised controlled parallel group superiority trial.

Setting—One large health board area with a materially deprived, inner city population in the west of Scotland, United Kingdom.

Participants—612 self reported pregnant smokers in NHS Greater Glasgow and Clyde who were English speaking, at least 16 years of age, less than 24 weeks pregnant, and had an exhaled carbon monoxide breath test result of 7 ppm or more. 306 women were randomised to incentives and 306 to control.

Interventions—The control group received routine care, which was the offer of a face to face appointment to discuss smoking and cessation and, for those who attended and set a quit date, the offer of free nicotine replacement therapy for 10 weeks provided by pharmacy services, and four, weekly support phone calls. The intervention group received routine care plus the offer of up to £400 (€560; $600)of shopping vouchers: £50 for attending a face to face appointment and setting a quit date; then another £50 if at four weeks’ post-quit date exhaled carbon monoxide confirmed quitting; a further £100 was provided for continued validated abstinence of exhaled carbon monoxide after 12 weeks; a final £200 voucher was provided for validated abstinence of exhaled carbon monoxide at 34-38 weeks’ gestation.

Main outcome measure—The primary outcome was cotinine verified cessation at 34-38 weeks’ gestation through saliva (<14.2 ng/mL) or urine (<44.7 ng/mL). Secondary outcomes included birth weight, engagement, and self reported quit at four weeks.

Results—Recruitment was …

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