Financial incentives help pregnant women quit smoking

Of 125 000 spontaneous miscarriages that occur each year in the United Kingdom, 125 000 are associated with smoking during pregnancy, assuming that 17% of women smoke during pregnancy, and the relative risk of spontaneous miscarriage compared with non-smokers is 1.2. If causality were accepted, then with a 20% increase in risk, 5000 miscarriages each year would be attributable to smoking during pregnancy.

Stillbirths occur at a rate of four for every 1000 live births, and 4-7% are attributable to smoking during pregnancy, accounting for approximately 180 deaths each year in the United Kingdom.

Infant deaths also occur at a rate of 4 per 1000 live births, and 3-5% are attributable to smoking during pregnancy—113 infant deaths each year.

In deprived areas, a third of excess stillbirths and postnatal deaths are explained by smoking during pregnancy. The total annual cost to the UK National Health Service of smoking during pregnancy is estimated to range between £8.1m ($12.3m; €10.4m) and £64m for treating the resulting problems in mothers, and between £12m and £23.5m in infants (aged 0-12 months).

In this research, Tappin et al set out to examine whether a financial incentive added to routine specialist pregnancy stop smoking services would be more effective at helping women quit.

They conclude that their randomised controlled trial provides substantial evidence for the efficacy of incentives for smoking cessation in pregnancy; but that as this was only a single centre trial, incentives should now be tested in different types of pregnancy cessation services and in different parts of the United Kingdom.

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