Public acceptability of financial incentives for smoking cessation in pregnancy and breast feeding: a survey of the British public

Pat Hoddinott, Heather Morgan, Graeme MacLennan, Kate Sewel, Gill Thomson, Linda Bauld, Deokhee Yi, Anne Ludbrook, Marion Kay Campbell

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Abstract

Objective To survey public attitudes about incentives for smoking cessation in pregnancy and for breast feeding to inform trial design.

Design Cross-sectional survey.

Setting and participants British general public.

Methods Seven promising incentive strategies had been identified from evidence syntheses and qualitative interview data from service users and providers. These were shopping vouchers for: (1) validated smoking cessation in pregnancy and (2) after birth; (3) for a smoke-free home; (4) for proven breast feeding; (5) a free breast pump; (6) payments to health services for reaching smoking cessation in pregnancy targets and (7) breastfeeding targets. Ipsos MORI used area quota sampling and home-administered computer-assisted questionnaires, with randomised question order to assess agreement with different incentives (measured on a five-point scale). Demographic data and target behaviour experience were recorded. Analysis used multivariable ordered logit models.

Results Agreement with incentives was mixed (ranging from 34% to 46%) among a representative sample of 1144 British adults. Mean agreement score was highest for a free breast pump, and lowest for incentives for smoking abstinence after birth. More women disagreed with shopping vouchers than men. Those with lower levels of education disagreed more with smoking cessation incentives and a breast pump. Those aged 44 or under agreed more with all incentive strategies compared with those aged 65 and over, particularly provider targets for smoking cessation. Non-white ethnic groups agreed particularly with breastfeeding incentives. Current smokers with previous stop attempts and respondents who had breast fed children agreed with providing vouchers for the respective behaviours. Up to £40/month vouchers for behaviour change were acceptable (>85%).

Conclusions Women and the less educated were more likely to disagree, but men and women of childbearing age to agree, with incentives designed for their benefit. Trials evaluating reach, impact on health inequalities and ethnic groups are required prior to implementing incentive interventions.
Original languageEnglish
Article numbere005524
JournalBMJ Open
Volume4
Issue number7
DOIs
Publication statusPublished - 18 Jul 2014

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Smoking Cessation
Breast Feeding
Motivation
Pregnancy
Breast
Ethnic Groups
Surveys and Questionnaires
Parturition
Smoke
Health Services
Cross-Sectional Studies
Logistic Models
Smoking
Demography
Interviews
Education
Health

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Public acceptability of financial incentives for smoking cessation in pregnancy and breast feeding : a survey of the British public. / Hoddinott, Pat; Morgan, Heather; MacLennan, Graeme; Sewel, Kate; Thomson, Gill; Bauld, Linda; Yi, Deokhee; Ludbrook, Anne; Campbell, Marion Kay.

In: BMJ Open, Vol. 4, No. 7, e005524, 18.07.2014.

Research output: Contribution to journalArticle

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abstract = "Objective To survey public attitudes about incentives for smoking cessation in pregnancy and for breast feeding to inform trial design.Design Cross-sectional survey.Setting and participants British general public.Methods Seven promising incentive strategies had been identified from evidence syntheses and qualitative interview data from service users and providers. These were shopping vouchers for: (1) validated smoking cessation in pregnancy and (2) after birth; (3) for a smoke-free home; (4) for proven breast feeding; (5) a free breast pump; (6) payments to health services for reaching smoking cessation in pregnancy targets and (7) breastfeeding targets. Ipsos MORI used area quota sampling and home-administered computer-assisted questionnaires, with randomised question order to assess agreement with different incentives (measured on a five-point scale). Demographic data and target behaviour experience were recorded. Analysis used multivariable ordered logit models.Results Agreement with incentives was mixed (ranging from 34{\%} to 46{\%}) among a representative sample of 1144 British adults. Mean agreement score was highest for a free breast pump, and lowest for incentives for smoking abstinence after birth. More women disagreed with shopping vouchers than men. Those with lower levels of education disagreed more with smoking cessation incentives and a breast pump. Those aged 44 or under agreed more with all incentive strategies compared with those aged 65 and over, particularly provider targets for smoking cessation. Non-white ethnic groups agreed particularly with breastfeeding incentives. Current smokers with previous stop attempts and respondents who had breast fed children agreed with providing vouchers for the respective behaviours. Up to £40/month vouchers for behaviour change were acceptable (>85{\%}).Conclusions Women and the less educated were more likely to disagree, but men and women of childbearing age to agree, with incentives designed for their benefit. Trials evaluating reach, impact on health inequalities and ethnic groups are required prior to implementing incentive interventions.",
author = "Pat Hoddinott and Heather Morgan and Graeme MacLennan and Kate Sewel and Gill Thomson and Linda Bauld and Deokhee Yi and Anne Ludbrook and Campbell, {Marion Kay}",
note = "Article Accepted Date: 24 June 2014 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ Acknowledgements: The authors would like to thank our coapplicants and research team: Mastrick Caf{\'e} Cr{\`e}che, Aberdeen and St Cuthbert’s and Palatine Children’s Centre, Blackpool. Shelley Farrar and Nicola Crossland contributed to the survey design. Grant co-applicants Professor Fiona Dykes, Professor David Tappin and Dr Falko Sniehotta for their collaboration and input to the overall BIBS study design. They also thank the members of the public, the women, families and staff from health services, local government, voluntary sector and other organisations, who generously provided their time by participating in the BIBS study. Other members of the BIBS study team, in particular, Fiona Stewart and Cynthia Fraser for providing guidance with literature searching and reference management; Lara Kemp for providing secretarial support. Funding: This project was commissioned by the NIHR Health Technology Assessment Programme (10/31/02) and will be published in full in Health Technology Assessment. Further information including the protocol is available at: http://www.nets.nihr.ac.uk/projects/hta/103102. This report presents independent research commissioned by the National Institute for Health Research (NIHR). The Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, the Health Services Research Unit, and Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen are all core-funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates.",
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T2 - a survey of the British public

AU - Hoddinott, Pat

AU - Morgan, Heather

AU - MacLennan, Graeme

AU - Sewel, Kate

AU - Thomson, Gill

AU - Bauld, Linda

AU - Yi, Deokhee

AU - Ludbrook, Anne

AU - Campbell, Marion Kay

N1 - Article Accepted Date: 24 June 2014 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ Acknowledgements: The authors would like to thank our coapplicants and research team: Mastrick Café Crèche, Aberdeen and St Cuthbert’s and Palatine Children’s Centre, Blackpool. Shelley Farrar and Nicola Crossland contributed to the survey design. Grant co-applicants Professor Fiona Dykes, Professor David Tappin and Dr Falko Sniehotta for their collaboration and input to the overall BIBS study design. They also thank the members of the public, the women, families and staff from health services, local government, voluntary sector and other organisations, who generously provided their time by participating in the BIBS study. Other members of the BIBS study team, in particular, Fiona Stewart and Cynthia Fraser for providing guidance with literature searching and reference management; Lara Kemp for providing secretarial support. Funding: This project was commissioned by the NIHR Health Technology Assessment Programme (10/31/02) and will be published in full in Health Technology Assessment. Further information including the protocol is available at: http://www.nets.nihr.ac.uk/projects/hta/103102. This report presents independent research commissioned by the National Institute for Health Research (NIHR). The Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, the Health Services Research Unit, and Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen are all core-funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates.

PY - 2014/7/18

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N2 - Objective To survey public attitudes about incentives for smoking cessation in pregnancy and for breast feeding to inform trial design.Design Cross-sectional survey.Setting and participants British general public.Methods Seven promising incentive strategies had been identified from evidence syntheses and qualitative interview data from service users and providers. These were shopping vouchers for: (1) validated smoking cessation in pregnancy and (2) after birth; (3) for a smoke-free home; (4) for proven breast feeding; (5) a free breast pump; (6) payments to health services for reaching smoking cessation in pregnancy targets and (7) breastfeeding targets. Ipsos MORI used area quota sampling and home-administered computer-assisted questionnaires, with randomised question order to assess agreement with different incentives (measured on a five-point scale). Demographic data and target behaviour experience were recorded. Analysis used multivariable ordered logit models.Results Agreement with incentives was mixed (ranging from 34% to 46%) among a representative sample of 1144 British adults. Mean agreement score was highest for a free breast pump, and lowest for incentives for smoking abstinence after birth. More women disagreed with shopping vouchers than men. Those with lower levels of education disagreed more with smoking cessation incentives and a breast pump. Those aged 44 or under agreed more with all incentive strategies compared with those aged 65 and over, particularly provider targets for smoking cessation. Non-white ethnic groups agreed particularly with breastfeeding incentives. Current smokers with previous stop attempts and respondents who had breast fed children agreed with providing vouchers for the respective behaviours. Up to £40/month vouchers for behaviour change were acceptable (>85%).Conclusions Women and the less educated were more likely to disagree, but men and women of childbearing age to agree, with incentives designed for their benefit. Trials evaluating reach, impact on health inequalities and ethnic groups are required prior to implementing incentive interventions.

AB - Objective To survey public attitudes about incentives for smoking cessation in pregnancy and for breast feeding to inform trial design.Design Cross-sectional survey.Setting and participants British general public.Methods Seven promising incentive strategies had been identified from evidence syntheses and qualitative interview data from service users and providers. These were shopping vouchers for: (1) validated smoking cessation in pregnancy and (2) after birth; (3) for a smoke-free home; (4) for proven breast feeding; (5) a free breast pump; (6) payments to health services for reaching smoking cessation in pregnancy targets and (7) breastfeeding targets. Ipsos MORI used area quota sampling and home-administered computer-assisted questionnaires, with randomised question order to assess agreement with different incentives (measured on a five-point scale). Demographic data and target behaviour experience were recorded. Analysis used multivariable ordered logit models.Results Agreement with incentives was mixed (ranging from 34% to 46%) among a representative sample of 1144 British adults. Mean agreement score was highest for a free breast pump, and lowest for incentives for smoking abstinence after birth. More women disagreed with shopping vouchers than men. Those with lower levels of education disagreed more with smoking cessation incentives and a breast pump. Those aged 44 or under agreed more with all incentive strategies compared with those aged 65 and over, particularly provider targets for smoking cessation. Non-white ethnic groups agreed particularly with breastfeeding incentives. Current smokers with previous stop attempts and respondents who had breast fed children agreed with providing vouchers for the respective behaviours. Up to £40/month vouchers for behaviour change were acceptable (>85%).Conclusions Women and the less educated were more likely to disagree, but men and women of childbearing age to agree, with incentives designed for their benefit. Trials evaluating reach, impact on health inequalities and ethnic groups are required prior to implementing incentive interventions.

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DO - 10.1136/bmjopen-2014-005524

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SN - 2044-6055

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