To hate the idea of the new smoking bribe?

[CharleyFarleyy]

What do people who dont smoke anyway get? seems like they are going to miss out un-fairly.

Also if quitting for your and your babys health isnt incentive enough will shopping vouchers help anyway?

It doesn't actually make any difference to the developing baby why the poison isn't being pumped into them anymore.

Just that it isn't.

This might sound a daft question, I apologise if it is! But what's to stop rejoining the scheme for subsequent pregnancies? That is, A could stop smoking in pregnancy number one via the scheme but start smoking again between birth and pregnancy number 2, will she be allowed to rejoin the scheme and therefore get another £400 of vouchers?

I don't know if there are rules on subsequent pregnancies, but if somebody was smoking 20 cigarettes a day, at £7 a packet, it would take 8-9 weeks to spend £400. Obviously not all of that is tax, so you could add a few weeks, but it's not worth starting smoking again purely to get the vouchers. And buy the time they were pregnant again, they've probably paid the equivalent amount of tax for the vouchers anyway.

Basically, if they thought it was worth starting smoking again in order to get more vouchers, they are kidding themselves and have sort of 'paid back' the vouchers anyway.

Bloody well done, BigCat, that's a massive achievement

Key facts for the hard of clicking:

• This was a randomised controlled trial involving 600 women in the Glasgow area which has 'large pockets of deprivation'

• 300 women were offered a face-to-face appointment with a smoking cessation adviser, as well as four follow-up phone calls and free nicotine replacement therapy for 10 weeks. This is the control group.

• The other 300 women were offered the same support, plus a total of £400 in vouchers: £50 at the first appointment, £50 after 4 weeks of quitting, £100 after 12 weeks and £200 towards the end of their pregnancy.

• The women used the vouchers at High Street stores such as Iceland, Argos and Mothercare.

• The women were breath-tested for carbon monoxide. They also had saliva, urine and blood cotinine tests to confirm they had quit.

• more than 20% of the women offered vouchers successfully stopped smoking, compared with 9% in the control group

(for comparison, this is from the study in the BMJ: 24% of pregnant women who attended their first antenatal booking appointment in Scotland self reported being smokers,but only one in 10 used evidence based NHS cessation services, with 3% reporting abstinence at four weeks after quitting - so even the 9% in the control group is 3x better than normal)

• After a year, 15% of women who received the vouchers had managed to stay off cigarettes, compared with 4% in the control group.

• One of the study's authors concluded 'This evidence shows that the money is the hand they need to pull them out of their addiction'

But some people do give up smoking only to start again - I know one person who shouldn't smoke due to a chronic lung condition, she successfully gave up but a period of stress and she started smoking again, I know another who gave up due to pregnancy but now is a light smoker - so it's not unreasonable to expect that there will be someone who does start up again post pregnancy... (I'm not saying for the sake of more vouchers) so I wonder if there is some rule about this otherwise there would be some women who get more than one lot of vouchers.

I'm not against the scheme in principle, I get what the aim is and some people need a motivation that they can't control... but I can see the other side of it too and tbh, I don't know what is right or not and I guess perhaps we have to focus on the baby rather than the benefits to the adults and lack of the vouchers to those who give up without the scheme

Ah so only 15% don't take up smoking again? That's actually quite a low number! Yes, I realise it's 11% more than without the scheme but still.. only 15%?

I think it's disgusting and mums that don't quit smoking in pregnancy are selfish twats that don't deserve children.

I don't care how harsh that is or if it offends people on here. There is no excuse to smoke during pregnancy - it is scum.

I'm fed up of going to my midwife appointments and seeing heavily pregnant fuck heads smoking outside the birthing unit after their appointments.

I would never wish anything upon any bodies child - howver I have a bmi of 23, I don't smoke or drink, I eat well and do a small amount of exercise. I'm 22 weeks pregnant and have just found out that my poor little baby has TGA - transversion of the great arteries = long story short his 2 arteries in his heart are the wrong way round and he will need to be born earlier and have open heart surgery within a few days of his life.

I would never wish this upon anyone's child wether they're a smoker or not but it makes me angry that people who do everything for their babies end up with things like this and selfish fuckers get healthy babies with no consequences.

It's an addiction. If it was that easy to give up, we wouldn't be offering people so much support, and their wouldn't be a whole industry dedicated to getting people to give up.

There has to be a point where calling it 'an addiction' is not a valid enough excuse.

If you can't quit smoking don't get pregnant. The fact is that a lot of women get pregnant knowing they are smoking and haven't been able to quit.

Sorry but no sympathy here - at all. There is no excuse in my mind that clears someone of knowingly harming their unborn baby for their own selfishness.

Yes, relapse is a massive problem. Most long term smokers have quit and relapsed numerous times and some successful quitters never ever stop missing smoking. The overall success rate for quit attempts is around 3% at 1 year so actually these results are astonishingly good.

If someone relapses they should be supported all over again because the alternative is they have a 50% chance of early death and continue to harm those around them, including their unborn children. They should be supported with the best methods we can possibly find and we should be thinking imaginatively about new methods of support because current stop smoking success rates are completely bloody dismal.

I guess perhaps we have to focus on the baby rather than the benefits to the adults

You can't separate the two. If the mother successfully quits, her child is no longer breathing SHS and no longer has a smoking role model - the biggest predictor of future smoking (and yes, we absolutely should be looking at fathers' smoking as well).

And really, let's look at the benefits to the adults here. Offering vouchers more than doubled these women's chances of successfully quitting. Remember that 50% chance of an early death - it's 10 years lost on average, usually preceded by years of dismal health. If you think they would rather start smoking again just for the sake of £400 you really do have a low opinion of smokers. Or women, or maybe just pregnant smoking women, who knows.

I think you're perspective is coloured by your own circumstances (and I'm very sorry you're going through it and I hope the best for your baby), but it's not as simple as 'just give up'. So many people try time and time again to give up, and they just can't manage it. You would hope that women who find themselves pregnant would want to try and give up, but calling them scum and saying they don't deserve their babies? That's a horrible thing to say.

*your.

bubalou I'm so sorry and I wish the best of luck to you and your LO

I don't doubt that the stats show vouchers help etc and that of course that is a good thing for the poor babies.

However how right is this!?! Who pays for these vouchers? I think they should be shamed into quitting on their own. Why wouldn't they!

I think nowadays we are far too polite with people - nobody can say anything about subjects like this, benefits, weight etc without everyone sticking up for the people that are a drain on the system.

ifyourhappy - I would say that my opinion is coloured by my circumstances but this is 100percent not the case.

I only found out last week about the baby.

My opinion of smoking in pregnancy was exactly the same two weeks ago and will not change.

I will not apologise for my opinion - my opinion is they are scum, selfish and excuse making people that shouldn't get pregnant if they can't be bothered to make the sacrifice of not smoking.

Thank you plenty

I have every confidence that he is going to be fine.

This is not a moral issue, it's a health crisis.

This was a study, it's not a scheme - they tried it to see if it would work and it does!

It could now go one of two ways -

• a scheme could be developed and rolled out. We could prevent lots more miscarriages, still births, low birth weights and SIDS. We could add years of good health to lots more people's lives, help lift them out of poverty and enable their children to grow up in smoke free homes.

or

• people could become so outraged that these stupid selfish cunts are getting something they're not - and something they don't deserve because they are stupid selfish cunts - that the scheme is a non-starter. So we carry on with a dismal 3% quit rate and lots more miscarriages, stillbirths, early deaths ... etc. etc. Still, it would mean there were still plenty of stupid selfish cunts around for people to pick on when they felt the need so it's not all bad.

Has there been any discussion on how much the vouchers are likely to be? An extra £20 won't make a difference to some people but £100 will.

I smoked for 15 years in all, stopped whilst pregnant both times but the first time I had PND after the birth, I started again & was not in a fit state to attempt to stop. The second time I stopped for good & haven't smoked since. I stopped cold turkey as I don't see why the NHS should pay for me to quit a self inflicted addiction.

In my situation, it was living with an EA husband who refused to stop smoking that meant I couldn't give up. Every time I tried he would be there in the corner of the room puffing away & that makes it nigh on impossible even if your will is strong. Once I left him & found DP who does not smoke, it was easier to give up. The point being that smoking ime can be dependant upon your situation & the people who surround you, once you have given birth then you're back with the people in the same place & the root cause has not been dealt with.

I think it's the terms 'reward' and 'incentive' that are so offensive. Because as many have stated - surely your babies health is important enough?

I think the sad fact is that in a society where obesity, smoking, drinking etc is all a big issue people are going to have a huge clash of opinions.

The bottom line is - it's not ok to smoke when pregnant but that's obvious. If something can be done to help the poor babies who are subject to this against their will from the mother then of course it should be.

It's just - shopping vouchers!?! Annoyed at the world today.

The thing is, this scheme didn't come out of nowhere. The whole issue of how we get people to adopt better health behaviours is v complex and difficult; in the main, a 'carrot' approach does seem to work more effectively than a 'stick' one. And the pilots using financial incentives appear to be effective too.

Smokers know exactly what the effects of smoking are. What they do not have is the motivation/ability/incentive/psychological resolve/whatever to stop. It is good for all of us to live in a smoke-free society. It's even better for foetuses to develop in a smoke-free environment. If the evidence shows - as it does, in this and in similar studies about other health behaviours - that a really quite small amount of cash makes a difference, I'm all for it.

But, you know, ignore the epidemiological hard evidence if you want to and just shout a lot.

As for who pays for the vouchers - I would expect that to come down to cost efficency.

i.e. Neo-natal costs currently associated with smokers babies are x. Based on quit rates from this trial, above costs could be reduced by y (fewer mums smoking thru all pregnancy = healthier babies = less need for extra medical care = NHS spends less). Factor in how much it costs to run the scheme.

So this could actually be a money saving venture for the NHS overall despite the vouchers being paid out.

But, you know, ignore the epidemiological hard evidence if you want to and just shout a lot.

You make a good point. There's a strong case for rewarding pregnant women for quitting smoking. But it is in fact a repellent idea.

... will she be allowed to rejoin the scheme and therefore get another £400 of vouchers?

I doubt it'll come to that - the cynic in me suggests that as with most of these "initiatives", the whole thing will probably be dropped once they've had a few good headlines out of it

That is rather the point, Goodbye. One person's 'repellent idea' is not another's. And different people have different motivations for their behaviour that are extremely difficult to change.

There is evidence that it works? That would in turn lead to better outcomes for two people and a net saving to the NHS?

I'm willing to leave my judgement of the individual at the door, as with so many health care issues, and say 'if this helps both the individuals and the NHS, let's try it, regardless of how tempting it would be to despise the individuals for having motivations I find weak or incomprehensible'.