An Incentive System to Reduce Smoking During Pregnancy

By Todd A. Ward, PhD, BCBA-D

Founding Editor,

A team of UK researchers lead by David Tappin recently published a Randomized Controlled Trial in the BMJ evaluating the effectiveness of financial incentives in a smoking cessation program for pregnant women.

The team recruited 612 women, half of which received standard health services through Glasgow NHS, including an initial in-person meeting and subsequent weekly phone calls related to smoking cessation and quitting dates.  Participants were also given free nicotine replacement therapy for 10 weeks.  The other participants received the before-mentioned services in addition to financial incentives.  The latter took the form of shopping vouchers contingent on the completion of various parts of the program, with the most valuable vouchers given contingent on a total absence of carbon monoxide detected after 34-38 weeks of pregnancy.

In short, the program worked fairly well. Over 22% of women in the incentive group completely stopped smoking, compared to 8.6% in the control group.  While not a majority by any means, the differences between the groups are significant.  Additionally, the babies born of mothers in the incentive group averaged 3140 grams at birth, compared to 3120 grams for babies born of mothers in the control group.

The research team was quick to point out the controversial nature of incentive programs for engaging in behavior many regard as something people are “supposed” to do (see a previous bSci21 article on this issue).  Additionally, the study is not without limitations, which can be read, along with many other details of the study, here.

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Todd A. Ward, PhD, BCBA-D is President of bSci21 Media, LLC, which owns and  Todd serves as an Associate Editor of the Journal of Organizational Behavior Management and as an editorial board member for Behavior and Social Issues.  He has worked as a behavior analyst in day centers, residential providers, homes, and schools, and served as the director of Behavior Analysis Online at the University of North Texas.  Todd’s areas of expertise include writing, entrepreneurship, Acceptance & Commitment Therapy, Instructional Design, Organizational Behavior Management, and ABA therapy. Todd can be reached at

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