Give It Up For Baby: outcomes and factors influencing uptake of a pilot smoking cessation incentive scheme for pregnant women

Abstract

BackgroundThe use of incentives to promote smoking cessation is a promising technique for increasing the effectiveness of interventions. This study evaluated the smoking cessation outcomes and factors associated with success for pregnant smokers who registered with a pilot incentivised smoking cessation scheme in a Scottish health board area (NHS Tayside).MethodsAll pregnant smokers who engaged with the scheme between March 2007 and December 2009 were included in the outcome evaluation which used routinely collected data. Data utilised included: the Scottish National Smoking Cessation Dataset; weekly and periodic carbon monoxide (CO) breath tests; status of smoking cessation quit attempts; and amount of incentive paid. Process evaluation incorporated in-depth interviews with a cross-sectional sample of service users, stratified according to level of engagement.ResultsQuit rates for those registering with Give It Up For Baby were 54% at 4 weeks, 32% at 12 weeks and 17% at 3 months post partum (all data validated by CO breath test). Among the population of women identified as smoking at first booking over a one year period, 20.1% engaged with Give It Up For Baby, with 7.8% of pregnant smokers quit at 4 weeks. Pregnant smokers from more affluent areas were more successful with their quit attempt. The process evaluation indicates financial incentives can encourage attendance at routine advisory sessions where they are seen to form part of a wider reward structure, but work less well with those on lowest incomes who demonstrate high reliance on the financial reward.ConclusionsUptake of Give It Up For Baby by the target population was higher than for all other health board areas offering specialist or equivalent cessation services in Scotland. Quit successes also compared favorably with other specialist interventions, adding to evidence of the benefits of incentives in this setting. The process evaluation helped to explain variations in retention and quit rates achieved by the scheme.This study describes a series of positive outcomes achieved through the use of incentives to promote smoking cessation amongst pregnant smokers.

Benefits of Incentives for Breastfeeding and Smoking cessation in pregnancy (BIBS): a mixed-methods study to inform trial design

“…In total, the full texts of 222 studies were therefore screened. In total, 23 studies (34 reports 25,68,104,105,[108][109][110][111]113, ) met our inclusion criteria. A flow diagram of the screening process is provided in Figure 4.…”

“…104,105,[108][109][110][111]113,[138][139][140][141][142][143][144][145][146][147][148][149][150] One study was included in the process review only as it was a survey of acceptability and feasibility and did not provide incentives to women. 151 One study 152 provided reimbursement to organisations providing care and one study included a question in a survey about reimbursement.…”

“…The overall quality of the qualitative content of the four included qualitative and mixed-methods studies, [109][110][111]113 assessed using CASP, 135 was high and the detail is presented in Table 3. 0 10 20 30 40 50 60 70 80 90 100 Were the inclusion/exclusion criteria clearly described?…”

“…For category B-D studies, women were invited to participate in a range of activities to obtain the incentives, some of which were reported as usual care plus additional components 110,111,138 or an enhanced programme of care 108,[145][146][147][148][149] or involved the implementation of a new protocol. 104,113,139,140,142,143,150 These programme components involved either one or a combination of advice, counselling, group sessions, written materials and motivational strategies and, in one study, a programme of supervised exercise. When extracting the IRBCT data, incentive and reward elements were identified reliably (kappa = 0.87).…”

“…Included studies were mostly from the USA, with three 109,113,148 set in the UK (see Table 5). The studies varied in terms of their funding sources.…”