Dr C: “Paying mums to quit cigs won’t work”

A local authority is trialling giving pregnant smokers a money incentive to encourage them to stop. Dr C is unconvinced

Paying pregnant women hundreds to quit smoking when the NHS is at breaking point is ridiculous, but next year Hertfordshire County Council will trial giving expectant mums up to £300 in vouchers for food, baby clothes and equipment to help them kick the habit. The women they are targeting are mainly from lower socioeconomic backgrounds, and using financial incentives to get them to do things feels wrong.

RISK OF NEW SMOKERS

Labour councillor Margaret Eames-Petersen expressed concern that some pregnant women might even start smoking just to get £300 of vouchers. It’s a valid concern – it’s as if they’re incentivising smoking. We already know that some young women smoke because they think they’ll give birth to a smaller baby. That’s awful enough – this could encourage even more.

IT’S TOUGH TO QUIT

Women will be paid an initial £50 in vouchers when they “set a date” to quit. They get another £50 after having stopped for a month, £100 after 12 weeks, and a final £100 at 34 weeks.

There’s some evidence that financial incentives work, but only in the short term. Giving up smoking is one of the hardest things you can do, so to make it seem like all it takes to get someone to ditch nicotine is a few vouchers sorely underestimates the challenge. It’s patronising and flawed. I doubt many women would willingly choose to do something that puts their unborn baby at risk, so they won’t suddenly find the ability to give up just because they’ve been offered £50 of free stuff.

The director of public health at the council said,

“We understand how difficult stopping smoking can be – our role is to offer non-judgemental help and support”. That’s a good sentiment, but the wrong way to do it. Sexual health and mental health services are being cut back to virtually nothing, and yet we’re handing out financial incentives to smokers. I believe in helping people quit smoking – but when other important services are on their knees, a scheme like this with £50,000 of incentives feel plain wrong.

THINK LONG-TERM

After the baby is born, and these mums are tired, hormonal and stressed, they’re likely to smoke again. They won’t have smoked during their pregnancy but it’s a short-term fix for a long-term problem. We’d be better off giving free vaping equipment if we want a long-term solution.