Monetary incentives aid smoking cessation among pregnant, post-partum women

Smoking during pregnancy is the leading preventable cause of poor pregnancy outcomes. Studies further indicate that in-utero smoke exposure contributes to respiratory and cardiac illnesses later in life.

The good news is that the prevalence of smoking during pregnancy has decreased. The bad news is that economically disadvantaged pregnant women continue to smoke at much higher rates than affluent women.

For the last three decades, developing more effective smoking cessation interventions for pregnant women - especially among vulnerable populations - has been a public health priority.

According to Stephen T. Higgins, Ph.D., director of the Vermont Center on Behavior and Health, which is funded in part by a National Institutes of Health Center of Biomedical Research Excellence award, there is one treatment that continues to stand out as the most efficacious and cost-effective: Financial incentives in the form of vouchers exchangeable for retail goods, like groceries and diapers.

During the U.S. cocaine epidemic of the 1980s and 1990s, when virtually all other treatments were failing miserably, Higgins initiated the use of monetary incentives along with intensive counseling to change behavior. The treatment approach became known as contingency management in the substance abuse field.

The approach, he explains, has been repeatedly shown to aid smoking cessation among pregnant and post-partum women, especially those who are economically disadvantaged. Higgins says this strategy is especially important for "those who work with this population and need to be aware of alternatives to the status quo."