Pregnant women are more likely to quit smoking if financial incentives are provided as part of their treatment plan. BMJ today.
Results show that smoking rewards women abstinence Voucher during pregnancy was associated with a continuous increase in abstinence rate compared to no voucher.
Smoking cessation is very important for healthy mothers and babies, but there is evidence that less than half of women who smoke daily have successfully quit smoking during pregnancy. Previous studies of financial incentives have shown promising results, but have not yet been put into practice.
Therefore, a team of French researchers decided to evaluate the effectiveness of progressively higher financial incentives that rely on continued smoking cessation. Birth results Among pregnant smokers.
Their findings are based on 460 pregnant smokers (mean age 29 years) in 18 obstetric wards in France, with financial incentive groups (231 females) or controls in less than 18 weeks. Randomly assigned to a group (229 women). Their pregnancy.
During the 6 face-to-face visits in 10 minutes, all participants were prompted to set an end date. Given motivational counseling; supported to prevent recurrence.
Control group participants received a € 20 (£ 17, $ 23) voucher at the end of each visit, but the abstinence was not rewarded, so the maximum amount a participant could earn after six visits was 120. It was euro.
However, members of the financial incentive group can earn additional vouchers depending on their abstinence (confirmed by the amount of carbon monoxide in the participants’ breathing at each visit). Therefore, if a participant is abstinent during 6 consecutive visits, he / she can get a voucher of up to € 520.
Potentially Important factorsOther (secondary) measurements such as time to recurrence, nicotine withdrawal symptoms, etc. were recorded at each visit, taking into account age, ethnicity, income, use of nicotine replacement therapy, etc. blood pressure, And the use of alcohol and cannabis for the last 30 days.
Secondary measurements of the newborn, such as gestational age (weekly) at birth, were also recorded. Birth weight, Head circumference, Apgar score at 5 minutes, and poor outcome (combined measurement of transfer to neonatal unit, birth defect, convulsions, or perinatal mortality).
On average, participants in the financial incentive group smoked 163 fewer cigarettes than participants in the control group.
The continuous abstinence rate was significantly higher in the financial incentive group (16%, 38 out of 231) than in the control group (7%, 17 out of 229), and the abstinence rate was contrasted on visits. Intervention rather than swarm
The time to recurrence occurred much later, and the craving for tobacco was lower in the financial incentive group than in the control group. There were no differences in nicotine withdrawal symptoms, blood pressure, cannabis or alcohol use.
Financial incentives were also associated with a 7% reduction in the risk of poor neonatal outcomes: 4 babies (2%) in the financial incentive group and 18 babies (9%) in the control group.
Further analysis suggests that infants in the financial incentive group are about twice as likely to weigh more than 2500g at birth. Control groupAlthough researchers say these results should be interpreted with caution.
Although this was a high-quality, well-designed trial with a relatively large number of participants, researchers found that there was a lack of follow-up of mothers and babies after childbirth and a lack of partner involvement in smoking interventions. , Points out some limitations.
Nonetheless, they say their results suggest that a monetary incentive to gradually reward smoking cessation “can be implemented in the routine medical care of pregnant smokers.”
Future studies need to evaluate the long-term efficacy of Financial incentives About smoking cessation after childbirth. “
This study increases evidence that it is the right time to start including incentives as part of standard practices to support. smoking Researchers in the linked editorial say discontinuation during pregnancy.
They argued that implementation should be pursued in parallel with ongoing and future research, and noted the need to integrate incentives into national best practice guidelines, along with appropriate ethical and cultural considerations. doing.
“Doing so will also play an important role in reducing health inequality in their earliest origins,” they conclude.
Financial Incentives for Smoking Cessation During Pregnancy: Multicenter Randomized Controlled Trials, BMJ (2021). www.bmj.com/content/375/bmj-2021-065217
British Medical Journal
Quote: Financial incentives help pregnant women quit smoking (December 1, 2021).
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