Incentivised smoking cessation intervention with pregnant women: findings from a pilot program in Northamptonshire, UK

Smoking is understood as the primary cause of preventable morbidity and premature death in the UK. In Northamptonshire, UK, the rate of smoking among adults was 20.9% (approximately 144,607 people) in 2011/12. Among pregnant women, compared to the national average (13.2%), the rate of smoking at time of delivery was higher in Northamptonshire (16%) in 2011/12. In terms of smoking cessation programs during pregnancy, incentivised smoking cessation schemes have been more frequently utilised when attempting to reduce rates of smoking among pregnant women. While smoking cessation interventions broadly accounted for a 6% increase in late-pregnancy abstinence rates compared to control interventions, only those that contained an incentivised component showed a significantly larger effect (RR 0.76, 95% CI 0.71 to 0.81). This paper presents preliminary findings of an incentivised smoking cessation pilot intervention in Northamptonshire which aimed to recruit 50 pregnant women who smoke and evaluate the feasibility of the incentive programme in terms of its: uptake of stop smoking services; numbers of those setting a quit date; effectiveness to reduce smoking following referral to stop smoking services (i.e. 4 weeks after quit date); effectiveness to reduce smoking status at delivery and the psychosocial outcomes of incentivised smoking cessation programs for pre- and post-natal women. This research applied a mixed quantitative and qualitative approach to assess the aggregated effectiveness of the program (through cross-sectional analysis) and understand individual-level positive and negative experiences of the program (through storytelling and in-depth interviews). We will report initial results (data collection currently underway) that will include baseline profile data and uptake of the incentive programme. It is important to note that gendered roles and experiences may make it more difficult for some women to access treatment and support for smoking cessation, given the heightened stigma surrounding smoking during pregnancy and mothers who smoke. This presentation will, therefore, also emphasize findings that report gendered influences on smoking such as partner influence, socioeconomic impact of lone-motherhood and individual, societal and structural stigma surrounding mothers that smoke.