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Published in: BMC Pregnancy and Childbirth 1/2012

Open Access 01-12-2012 | Research article

The effectiveness of financial incentives for smoking cessation during pregnancy: is it from being paid or from the extra aid?

Authors: Eleni Mantzari, Florian Vogt, Theresa M Marteau

Published in: BMC Pregnancy and Childbirth | Issue 1/2012

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Abstract

Background

Financial incentives appear to be effective in promoting smoking cessation in pregnancy. The mechanisms by which they might operate however, are poorly understood. The present study examines how financial incentives for smoking cessation during pregnancy may work, by exploring pregnant women's experiences of trying to stop smoking, within and outside of a financial incentives scheme.

Methods

Thirty-six (n = 36) UK-based pregnant smokers (n = 36), offered standard NHS Stop-Smoking Services, of whom twenty (n = 20) were enrolled in a financial incentives scheme for smoking cessation (n = 20) and sixteen (n = 16) were not, were interviewed about (i) their motivation to stop smoking, and (ii) the factors they perceived as influencing their quitting efforts. Framework Analysis was used to analyse the data.

Results

Women in the two groups reported similar reasons for wanting to stop smoking during pregnancy. However, they described dissimilar experiences of the Stop-Smoking Services, which they perceived to have differentially influenced their quit attempts. Women who were incentivised reported using the services more than women who were not incentivised. In addition, they described the motivating experience of being monitored and receiving feedback on their progress. Non-incentivised women reported problems receiving the appropriate Nicotine Replacement Therapy, which they described as having a detrimental effect on their quitting efforts.

Conclusion

Women participating in a financial incentives scheme to stop smoking reported greater engagement with the Stop-Smoking Services, from which they described receiving more help in quitting than women who were not part of the scheme. These results highlight the complexity of financial incentives schemes and the intricacies surrounding the ways in which they operate to affect smoking cessation. These might involve influencing individuals' motivation and self-regulation, changing engagement with and provision of support services, or a combination of these.
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Literature
1.
go back to reference Floyd RL, Rimer BK, Giovino GA, Mullen PD, Sullivan SE: A review of smoking in pregnancy: effects on pregnancy outcomes and cessation efforts. Annu Rev Public Health. 1993, 14 (1): 379-411. 10.1146/annurev.pu.14.050193.002115.CrossRefPubMed Floyd RL, Rimer BK, Giovino GA, Mullen PD, Sullivan SE: A review of smoking in pregnancy: effects on pregnancy outcomes and cessation efforts. Annu Rev Public Health. 1993, 14 (1): 379-411. 10.1146/annurev.pu.14.050193.002115.CrossRefPubMed
2.
go back to reference Power C, Mathews S: Origins of health inequalities in a national population sample. Lancet. 1997, 350 (9091): 1584-1589. 10.1016/S0140-6736(97)07474-6.CrossRefPubMed Power C, Mathews S: Origins of health inequalities in a national population sample. Lancet. 1997, 350 (9091): 1584-1589. 10.1016/S0140-6736(97)07474-6.CrossRefPubMed
3.
go back to reference Royal College of Physicians: Smoking and the young: A report of the working party of the Royal College of Physicians London. 1992 Royal College of Physicians: Smoking and the young: A report of the working party of the Royal College of Physicians London. 1992
5.
go back to reference Batstra L, Hadders-Algra M, Neeleman J: Effect of antenatal exposure to maternal smoking on behavioural problems and academic achievement in childhood. Early Hum Dev. 2003, 75: 21-33.CrossRefPubMed Batstra L, Hadders-Algra M, Neeleman J: Effect of antenatal exposure to maternal smoking on behavioural problems and academic achievement in childhood. Early Hum Dev. 2003, 75: 21-33.CrossRefPubMed
7.
go back to reference Dolan-Mullen P, Ramirez G, Groff JY: A meta-anaysis of randomized trials of prenatal smoking cessation interventions. Am J Obstet Gynecol. 1994, 171 (5): 1328-1334.CrossRefPubMed Dolan-Mullen P, Ramirez G, Groff JY: A meta-anaysis of randomized trials of prenatal smoking cessation interventions. Am J Obstet Gynecol. 1994, 171 (5): 1328-1334.CrossRefPubMed
8.
go back to reference Lumley J, Oliver S, Waters E: Interventions for promoting smoking cessation during pregnancy. The Cochrane Database of Systematic Reviews. Issue. Art. No.: CD001055. DOI: 10.1002/14651858.CD001055 Lumley J, Oliver S, Waters E: Interventions for promoting smoking cessation during pregnancy. The Cochrane Database of Systematic Reviews. Issue. Art. No.: CD001055. DOI: 10.1002/14651858.CD001055
9.
go back to reference Lumley J, Chamberlain C, Dowswell T, Oliver S, Oakley L, Watson L: Interventions for promoting smoking cessation during pregnancy. Cochrane Database of Systematic Reviews. 2009, Art. No.: CD001055. DOI: 10.1002/14651858.CD001055.pub3, 3CrossRef Lumley J, Chamberlain C, Dowswell T, Oliver S, Oakley L, Watson L: Interventions for promoting smoking cessation during pregnancy. Cochrane Database of Systematic Reviews. 2009, Art. No.: CD001055. DOI: 10.1002/14651858.CD001055.pub3, 3CrossRef
10.
go back to reference Sexton M, Hebel JR: A clinical trial of change in maternal smoking and its effect on birth weight. JAMA. 1984, 251 (7): 911-915. 10.1001/jama.1984.03340310025013.CrossRefPubMed Sexton M, Hebel JR: A clinical trial of change in maternal smoking and its effect on birth weight. JAMA. 1984, 251 (7): 911-915. 10.1001/jama.1984.03340310025013.CrossRefPubMed
11.
go back to reference Donatelle RJ, Prows SL, Champeau D, Hudson D: Randomised controlled trial using social support and financial incentives for high risk pregnant smokers: Significant Other Supporter (SOS) program. Tob Control. 2000, 9: 67-69.CrossRef Donatelle RJ, Prows SL, Champeau D, Hudson D: Randomised controlled trial using social support and financial incentives for high risk pregnant smokers: Significant Other Supporter (SOS) program. Tob Control. 2000, 9: 67-69.CrossRef
12.
go back to reference Higgins ST, Hei SH, Solomon LJ, Bernstein IM, Lussier JP, Abel RL, Lynch ME, Badger GJ: A pilot study on voucher-based incentives to promote abstinence from cigarette smoking during pregnancy and postpartum. Nicotine Tob Res. 2004, 6 (6): 1015-1020. 10.1080/14622200412331324910.CrossRefPubMed Higgins ST, Hei SH, Solomon LJ, Bernstein IM, Lussier JP, Abel RL, Lynch ME, Badger GJ: A pilot study on voucher-based incentives to promote abstinence from cigarette smoking during pregnancy and postpartum. Nicotine Tob Res. 2004, 6 (6): 1015-1020. 10.1080/14622200412331324910.CrossRefPubMed
13.
go back to reference Heil SH, Higgins ST, Bernstein IM, Solomon LJ, Rogers RE, Thomas CS, Badger GJ, Lynch ME: Effects of voucher-based incentives on abstinence from cigarette smoking and fetal growth among pregnant women. Addiction. 2008, 103 (6): 1009-1018. 10.1111/j.1360-0443.2008.02237.x.CrossRefPubMedPubMedCentral Heil SH, Higgins ST, Bernstein IM, Solomon LJ, Rogers RE, Thomas CS, Badger GJ, Lynch ME: Effects of voucher-based incentives on abstinence from cigarette smoking and fetal growth among pregnant women. Addiction. 2008, 103 (6): 1009-1018. 10.1111/j.1360-0443.2008.02237.x.CrossRefPubMedPubMedCentral
14.
go back to reference Bauld L, Coleman T: The effectiveness of smoking cessation interventions during pregnancy: A briefing paper. 2009, London: National Institute for Health and Clinical Excellence Bauld L, Coleman T: The effectiveness of smoking cessation interventions during pregnancy: A briefing paper. 2009, London: National Institute for Health and Clinical Excellence
16.
go back to reference Bandura A: Social foundations of thought and action: A social cognitive theory. 1986, Englewood Cliffs, NJ: Prentice-Hall Bandura A: Social foundations of thought and action: A social cognitive theory. 1986, Englewood Cliffs, NJ: Prentice-Hall
17.
go back to reference Johnston M, Sniehotta F: Financial incentives to change patient behaviour. J Health Serv Res Policy. 2010, 15: 131-132. 10.1258/jhsrp.2010.010048.CrossRefPubMed Johnston M, Sniehotta F: Financial incentives to change patient behaviour. J Health Serv Res Policy. 2010, 15: 131-132. 10.1258/jhsrp.2010.010048.CrossRefPubMed
18.
go back to reference Bosch-Capblanch X, Abba K, Prictor M, Garner P: Contracts between patients and healthcare practitioners for improving patients' adherence to treatment, prevention and health promotion activities. Cochrane Database Syst Rev. 2007, 2 (Art. No): CD004808-PubMed Bosch-Capblanch X, Abba K, Prictor M, Garner P: Contracts between patients and healthcare practitioners for improving patients' adherence to treatment, prevention and health promotion activities. Cochrane Database Syst Rev. 2007, 2 (Art. No): CD004808-PubMed
19.
go back to reference Bonner SE: Judgment and decision-making research in accounting. Accounting Horizons. 1999, 13: 385-398. 10.2308/acch.1999.13.4.385.CrossRef Bonner SE: Judgment and decision-making research in accounting. Accounting Horizons. 1999, 13: 385-398. 10.2308/acch.1999.13.4.385.CrossRef
20.
go back to reference Guest G, Bunce R, Johnson L: How many interviews are enough? An experiment with data saturation and variability. Field Methods. 2006, 18: 59-82. 10.1177/1525822X05279903.CrossRef Guest G, Bunce R, Johnson L: How many interviews are enough? An experiment with data saturation and variability. Field Methods. 2006, 18: 59-82. 10.1177/1525822X05279903.CrossRef
21.
go back to reference Kuzel A: Sampling in qualitative inquiry. Doing qualitative research. Edited by: Crabtree B, Miller W. 1992, Newbury Park, CA: Sage, 31-44. Kuzel A: Sampling in qualitative inquiry. Doing qualitative research. Edited by: Crabtree B, Miller W. 1992, Newbury Park, CA: Sage, 31-44.
22.
go back to reference Morse J: Designing funded qualitative research. Handbook for qualitative research. Edited by: Denzin N, Lincoln Y. 1994, Thousand Oaks, CA: Sage, 220-235. Morse J: Designing funded qualitative research. Handbook for qualitative research. Edited by: Denzin N, Lincoln Y. 1994, Thousand Oaks, CA: Sage, 220-235.
25.
go back to reference Hawkins SS, Lamb K, Cole TJ, Law C: Influence of moving to the UK on maternal health behaviours: prospective cohort study. Br Med J. 2008, 336 (7652): 1052-1055. 10.1136/bmj.39532.688877.25.CrossRef Hawkins SS, Lamb K, Cole TJ, Law C: Influence of moving to the UK on maternal health behaviours: prospective cohort study. Br Med J. 2008, 336 (7652): 1052-1055. 10.1136/bmj.39532.688877.25.CrossRef
27.
go back to reference Ritchie J, Spencer L: Qualitative data analysis for applied policy research. Analyzing qualitative data. Edited by: Bryman A, Burgess RG. 1994, Oxon: Routledge, 173-193.CrossRef Ritchie J, Spencer L: Qualitative data analysis for applied policy research. Analyzing qualitative data. Edited by: Bryman A, Burgess RG. 1994, Oxon: Routledge, 173-193.CrossRef
28.
go back to reference Kim A, Kamyab K, Zhu J, Volpp K: Why are financial incentives not effective at influencing some smokers to quit? Results of a process evaluation of a worksite trial assessing the efficacy of financial incentives for smoking cessation. J Occup Environ Med. 2011, 53 (1): 62-67. 10.1097/JOM.0b013e31820061d7.CrossRefPubMed Kim A, Kamyab K, Zhu J, Volpp K: Why are financial incentives not effective at influencing some smokers to quit? Results of a process evaluation of a worksite trial assessing the efficacy of financial incentives for smoking cessation. J Occup Environ Med. 2011, 53 (1): 62-67. 10.1097/JOM.0b013e31820061d7.CrossRefPubMed
29.
go back to reference Aarts H, Dijksterhuis A: Habits as knowledge structures: automaticity in goal-directed behavior. J Pers Soc Psychol. 2000, 78: 53-63.CrossRefPubMed Aarts H, Dijksterhuis A: Habits as knowledge structures: automaticity in goal-directed behavior. J Pers Soc Psychol. 2000, 78: 53-63.CrossRefPubMed
30.
go back to reference Bargh JA, Gollwitzer PM, Lee-Chai A, Barndollar K, Trötschel R: The automated will: nonconscious activation and pursuit of behavioral goals. J Pers Soc Psychol. 2001, 81 (6): 1014-1027.CrossRefPubMedPubMedCentral Bargh JA, Gollwitzer PM, Lee-Chai A, Barndollar K, Trötschel R: The automated will: nonconscious activation and pursuit of behavioral goals. J Pers Soc Psychol. 2001, 81 (6): 1014-1027.CrossRefPubMedPubMedCentral
31.
go back to reference Moskowitz GB, Li P, Kirk ER: The implicit volition model: On the preconscious regulation of temporarily adopted goals. Advances in Experimental Social Psychology. Edited by: Zanna M. 2004, San Diego, CA: Academic Moskowitz GB, Li P, Kirk ER: The implicit volition model: On the preconscious regulation of temporarily adopted goals. Advances in Experimental Social Psychology. Edited by: Zanna M. 2004, San Diego, CA: Academic
32.
go back to reference Meloy MG, Russo JE, Miller EG: Monetary incentives and mood. J Mark Res. 2006, 43 (2): 267-275. 10.1509/jmkr.43.2.267.CrossRef Meloy MG, Russo JE, Miller EG: Monetary incentives and mood. J Mark Res. 2006, 43 (2): 267-275. 10.1509/jmkr.43.2.267.CrossRef
33.
go back to reference Aarts H: Health and goal-directed behavior: the nonconscious regulation and motivation of goals and their pursuit. Health Psychology Rev. 2007, 1 (1): 53-82. 10.1080/17437190701485852.CrossRef Aarts H: Health and goal-directed behavior: the nonconscious regulation and motivation of goals and their pursuit. Health Psychology Rev. 2007, 1 (1): 53-82. 10.1080/17437190701485852.CrossRef
34.
go back to reference NHS Leicestershire and Rutland: News Release: Helping Pregnant Smokers to Quit. 2009. From YouGov plc Poll: Total sample size was 2136 adults. Fieldwork was undertaken between 16th - 19th January 2009. The survey was carried out online. The figures have been weighted and are representative of all GB adults (aged 18+). NHS Leicestershire and Rutland: News Release: Helping Pregnant Smokers to Quit. 2009. From YouGov plc Poll: Total sample size was 2136 adults. Fieldwork was undertaken between 16th - 19th January 2009. The survey was carried out online. The figures have been weighted and are representative of all GB adults (aged 18+).
35.
go back to reference Bondas T, Eriksson K: Women's lived experiences of pregnancy: a tapestry of joy and suffering. Qual Health Res. 2001, 11: 824-840. 10.1177/104973201129119415.CrossRefPubMed Bondas T, Eriksson K: Women's lived experiences of pregnancy: a tapestry of joy and suffering. Qual Health Res. 2001, 11: 824-840. 10.1177/104973201129119415.CrossRefPubMed
36.
go back to reference Bull L, Burke R, Walsh S, Whitehead E: Social attitudes towards smoking in pregnancy in East Surrey: a qualitative study of smokers, former smokers and non-smokers. J Neonatal Nursing. 2007, 13: 100-106. 10.1016/j.jnn.2007.01.002.CrossRef Bull L, Burke R, Walsh S, Whitehead E: Social attitudes towards smoking in pregnancy in East Surrey: a qualitative study of smokers, former smokers and non-smokers. J Neonatal Nursing. 2007, 13: 100-106. 10.1016/j.jnn.2007.01.002.CrossRef
37.
go back to reference Promberger M, Brown RCH, Ashcroft RE, Marteau TM: Acceptability of financial incentives to improve health outcomes in UK and US samples. J Med Ethics. 2011, 37: 682-687. 10.1136/jme.2010.039347.CrossRefPubMedPubMedCentral Promberger M, Brown RCH, Ashcroft RE, Marteau TM: Acceptability of financial incentives to improve health outcomes in UK and US samples. J Med Ethics. 2011, 37: 682-687. 10.1136/jme.2010.039347.CrossRefPubMedPubMedCentral
38.
go back to reference Long JA, Helweg-Larsen M, Volpp KG: Patient opinions regarding 'Pay for performance for patients'. J Gen Intern Med. 2008, 23 (10): 1647-1652. 10.1007/s11606-008-0739-1.CrossRefPubMedPubMedCentral Long JA, Helweg-Larsen M, Volpp KG: Patient opinions regarding 'Pay for performance for patients'. J Gen Intern Med. 2008, 23 (10): 1647-1652. 10.1007/s11606-008-0739-1.CrossRefPubMedPubMedCentral
39.
go back to reference Zajonc RB: Attitudinal effects of mere exposure. Journal of Personality and Social Psychology Monograph Supplement. 1968, 9: 1-28.CrossRef Zajonc RB: Attitudinal effects of mere exposure. Journal of Personality and Social Psychology Monograph Supplement. 1968, 9: 1-28.CrossRef
40.
go back to reference Bornstein BF: Exposure and affect: overviewand meta-analysis of research 1968-1987. Psychol Bull. 1989, 106 (2): 265-289.CrossRef Bornstein BF: Exposure and affect: overviewand meta-analysis of research 1968-1987. Psychol Bull. 1989, 106 (2): 265-289.CrossRef
41.
go back to reference Bornstein BF, D'Agostino PR: Stimulus recognition and the Mere exposure effect. J Pers Soc Psychol. 1992, 63 (4): 545-552.CrossRefPubMed Bornstein BF, D'Agostino PR: Stimulus recognition and the Mere exposure effect. J Pers Soc Psychol. 1992, 63 (4): 545-552.CrossRefPubMed
42.
go back to reference Isen AM: Positive-affect and decision making. Handbook of emotions. Edited by: Lewis M, Haviland J. 1993, New York: Guilford Press, 261-277. Isen AM: Positive-affect and decision making. Handbook of emotions. Edited by: Lewis M, Haviland J. 1993, New York: Guilford Press, 261-277.
43.
go back to reference Weiss HM, Nicholas JP, Daus CS: An examination of the joint effects of affective experiences and job beliefs on job satisfaction and variations in affective experiences over time. Organ Behav Hum Decis Process. 1999, 78: 1-24. 10.1006/obhd.1999.2824.CrossRefPubMed Weiss HM, Nicholas JP, Daus CS: An examination of the joint effects of affective experiences and job beliefs on job satisfaction and variations in affective experiences over time. Organ Behav Hum Decis Process. 1999, 78: 1-24. 10.1006/obhd.1999.2824.CrossRefPubMed
44.
go back to reference Isen AM: Positive affect. Handbook of Cognition and Emotion. Edited by: Dagleish T, Powers M. 1999, Sussex, England: Wiley Isen AM: Positive affect. Handbook of Cognition and Emotion. Edited by: Dagleish T, Powers M. 1999, Sussex, England: Wiley
45.
go back to reference Kim J, Lim JS, Bhargava M: The role of affect in attiude formation: a classical conditioning approach. J Acad Mark Sci. 1998, 26 (2): 143-152. 10.1177/0092070398262005.CrossRef Kim J, Lim JS, Bhargava M: The role of affect in attiude formation: a classical conditioning approach. J Acad Mark Sci. 1998, 26 (2): 143-152. 10.1177/0092070398262005.CrossRef
46.
go back to reference Allen CT, Madden TJ: A closer look at classical conditioning. J Consum Res. 1985, 12: 301-315. 10.1086/208517.CrossRef Allen CT, Madden TJ: A closer look at classical conditioning. J Consum Res. 1985, 12: 301-315. 10.1086/208517.CrossRef
47.
go back to reference Shimp TA: Neo-pavlovian conditioning and its implications for consumer theory and research. Handbook of Consumer Behavior. Edited by: Robertson TS, Kassarjian HH. 1991, Englewood Cliffs, NJ: Prentice Hall, 162-187. Shimp TA: Neo-pavlovian conditioning and its implications for consumer theory and research. Handbook of Consumer Behavior. Edited by: Robertson TS, Kassarjian HH. 1991, Englewood Cliffs, NJ: Prentice Hall, 162-187.
50.
go back to reference May S, McEwen A: NHS Stop Smoking Service CO-verification project. 2008, London: Smoking Cessation Service Research Network (SCSRN) May S, McEwen A: NHS Stop Smoking Service CO-verification project. 2008, London: Smoking Cessation Service Research Network (SCSRN)
51.
go back to reference Bize R, Burnand B, Mueller Y, Cornuz J: Biomedical risk assessment as an aid for smoking cessation. Cochrane Database Syst Rev. 2009, 2 (Art. No): CD004705-PubMed Bize R, Burnand B, Mueller Y, Cornuz J: Biomedical risk assessment as an aid for smoking cessation. Cochrane Database Syst Rev. 2009, 2 (Art. No): CD004705-PubMed
Metadata
Title
The effectiveness of financial incentives for smoking cessation during pregnancy: is it from being paid or from the extra aid?
Authors
Eleni Mantzari
Florian Vogt
Theresa M Marteau
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2012
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-12-24

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