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Medical experts divided over plan to pay pregnant women £400 in shop vouchers to quit smoking

By Victoria O'Hara

Pregnant women in Northern Ireland who smoke could be involved in trials that offer them shopping vouchers to help them quit the habit.

Researchers in a trial in Glasgow revealed that women who received vouchers worth £400 were more likely to stop smoking.

Six hundred women were involved and more than 20% of those offered vouchers stopped smoking, compared with 9% given normal NHS support alone.

Now there are proposals to extend the medical trials, depending on funding.

In order to ensure the intervention works, trials have been proposed in Northern Ireland, Lanarkshire, Nottingham and south London.

But it has sparked conflicting responses among medical professionals, who have questioned whether funds should be invested in pilot schemes.

Dr Carolyn Mason, head of professional development with the Royal College of Nurses in Northern Ireland, said support should be given to people trying to quit smoking but not at the expense of other services. "If we give pregnant women £400 to stop smoking, how much should we give to overweight people to support them to eat less?

"Or to other people who smoke to help them avoid lung diseases that ruin lives, while at the same time support for people with other addictions is already being pulled back, care for older people, or breast screening, or immunisations? Yes, let's give all the support possible, and in an ideal world along with a £400 cheque, but not right now and at the expense of other services"

Dr Vinod Tohani, chair of the public health committee at BMA Northern Ireland, said more research was needed.

"The results of this study may show that economic incentives such as shopping vouchers can lead to a reduction in smoking, however it is crucial that follow-up studies are carried out to determine that such initiatives lead to smokers stopping smoking on a long-term basis and not just for the duration of a financially incentivised study."

Dr George O'Neill from Addiction NI is supportive of the trials, saying that such pilots have been shown to work.

"Previous trials have been successful and are rigorously managed through urine and saliva checks. What they are doing at present is using nicotine patches and chewing gum - all sorts of substitutes that cost money anyway. So the health service are spending funding on it anyway. This could be a better way to spend money."

A decision on whether the team receives the £2m funding from the National Institute for Health Research for is expected in weeks.

Novel approach to weaning mums-to-be off the cigs

Q. How did the trial work in  financial terms?

A. Researchers assigned 600 women in Glasgow into two groups. One group was offered a face-to-face appointment with a smoking cessation adviser, four follow-up phone calls and free nicotine replacement therapy for 10 weeks. The financial incentive group received standard support as well as £50 at their first appointment, £50 if a breath test later suggested they had stopped smoking, and a further £100 after another 12 weeks. A final £200 voucher was given if another breath test at 34-38 weeks in pregnancy confirmed there was no carbon monoxide exhaled.

Q. How were the women monitored?

A. Women had breath tests, providing saliva and urine samples to check if they were smoking. Blood samples were monitored too.

Q. What did the tests discover?

A. More than 20% of those offered vouchers stopped smoking, compared with 9% given normal NHS support.

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