New study finds financial incentives to help pregnant women stop smoking are highly cost-effective

Smoking during pregnancy is among the leading preventable causes of morbidity and death amongst pregnant women and their babies. In some countries, a range of services exist to help pregnant smokers quit, but engagement with services is low. It has been found that financial incentives can increase engagement with stop-smoking services and improve the chances of quitting, but commentators have been concerned about whether the benefits are worth the financial outlay.

The report published was based on a Glasgow-based randomised controlled trial of over 600 pregnant smokers. All were referred to the NHS GGC Stop Smoking Services and half also received up to £400 in vouchers for engaging with the Stop Smoking Services and for quitting during pregnancy. The women offered financial incentives quit smoking at a much higher rate than those not offered incentives (22.5% versus 8.6%), and their self-reported relapse rates 6 months postpartum were also lower (33% versus 54%).

The key finding of this new study was that the benefits made these incentives a sound financial investment. The study estimated the lifetime likelihood and impact of cessation, expressing the long-term health benefits of quitting smoking in terms of quality-adjusted life years (QALYs) gained and the likely reduction in costs to the health services. The lifetime model resulted in a cost of £17 ($26) and a gain of 0.04 QALYs per quitter, giving cost per QALY of £482 ($734). The UK threshold (comparable to thresholds in other high income countries) is £20,000 per QALY, meaning the UK will support interventions that cost no more than £20,000 to provide one person with one year of life in perfect health.