MCHbest. NPM 14.1: Smoking in Pregnancy
Approach. Provide incentives to reduce smoking during pregnancy.
Overview. Interventions that offer material incentives in an effort to change behavior – whether in the form of cash, vouchers, discounts, gift cards, or baby products – have proven to be effective in encouraging pregnant smokers to quit. Evidence from recent studies build on earlier findings that support both the efficacy and cost-effectiveness of contingency-based financial incentives as a smoking deterrent. Not only are such incentives effective in reducing the number of pregnant women who smoke, but the cost of such interventions are comparable to other effective smoking-cessation interventions already in use.1
Evidence. Moderate. Research has consistently shown positive results for this smoking-cessation strategy. Providing contingency-based Incentives, combined with standard care, has been tested more than once and the results are positive. The added incentive is likely to increase the likelihood of quitting among pregnant women who smoke, compared with those who receive the standard care only. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).
Target Audience. Pregnant women who smoke.
Outcome. Smoking cessation during pregnancy. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.
Examples from the Field. There are currently 6 ESMs across all states/jurisdictions that uses this strategy. Access descriptions of these ESMs through the MCH Digital Library. You can use these ESMs to see how other Title V agencies are addressing the NPM.
Sample ESMs. Using the approach “Provide incentives to reduce smoking during pregnancy,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):
- Number of pregnant women who receive incentives to quit smoking.
- Percent of pregnant women who report that incentives provided added motivation to quit smoking.
- Number of pregnant women who received incentives and quit or reduced smoking.
- Percent of pregnant women who received incentives and quit or reduced smoking.
Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).
1 Boyd KA, Briggs AH, Bauld L, et al. Are financial incentives cost-effective to support smoking cessation during pregnancy? Addiction. 2015 Sep 15; Seminal study supporting the cost-effectiveness of financial incentives for smoking cessation with pregnant and newly postpartum women.