Financial incentives to stop smoking during pregnancy and to breastfeed backed by younger people

Men and women aged 44 or younger are more likely to agree with financial incentives to encourage women to stop smoking during pregnancy and to breast feed compared to those aged 65 and over.

This was a key finding of new research carried out by the University of Stirling, which aimed to assess public acceptance of financial incentives to encourage healthy lifestyle choices. The study also found that people with higher qualifications, or from non-white ethnic groups, and men, were more likely to support the incentives.

Pilot schemes in different parts of UK have offered pregnant women and new mothers a range of incentives including shopping vouchers in an effort to encourage women to adopt healthy lifestyles. Previous research has suggested these financial incentives can help to motivate women to make the best decisions for their baby's health.

This study examined existing research to consider what made it easier for women to continue breastfeeding and stop smoking and drew up a list of the seven most promising types of incentives. Over 1000 members of the British general public from a cross section of society were then asked for their views.

Overall, the researchers found between a third to just under a half (34%-46%) of British adults surveyed agreed with one or more types of incentives. A free breast pump was found to be the most popular.

Lead researcher, Professor Pat Hoddinott from the University of Stirling's Nursing, Midwifery and Allied Health Professional Research Unit said: "Addressing health inequalities is a government priority so the implications of our research for efforts to reduce this inequity are important.

"Our findings are a concern because the highest levels of smoking during pregnancy and the lowest rates of breastfeeding are amongst the less educated and white British women, two of the groups showing lower levels of support for incentives."

Co-author Dr Heather Morgan of the University of Aberdeen said: "There are many reasons why some women continue to smoke in pregnancy and do not breastfeed. External influences, such as family and friends, work and the provision of additional support by health services, can all influence women's ability to make these lifestyle changes."

Dr Gill Thomson, a member of the research team from the University of Central Lancashire, said: "Evidence suggests incentives to promote behaviour change can be successful, because they can facilitate better relationships between recipients and care providers and can reassure people of their worthiness to receive help.

"However, this study tells us there are still challenges ahead in promoting the benefits to certain groups, particularly those who dislike pressure to behave in the way that the health service would like them to."

Professor Hoddinott added: "If incentives are offered to women and they don't work, women can feel very demoralised, particularly as every mother sets out to do the best for her baby. Some women may need other forms of support in addition to the incentive because healthy lifestyle choices can be difficult to maintain."

Senior Consultant Obstetricain Mr Ashok Kumar commenting on the study said: "It is important that we look at a range of ways of supporting women to make the best choices for their babies."

The study concludes that more research is needed to evaluate the reach and impact on health inequalities and ethnic groups of potential incentives before they are implemented across the UK.

The research, which was published in BMJ Openwas funded by the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme.

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