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?

Are you one of those posters who goes on the foodbank threads and says 'let them eat pulses'?

This 'plaster on a gaping wound' actually works better than any other measure I have ever seen. People are experts on their own lives, even poor people who make 'bad' choices. Their choices are usually perfectly rational once you properly understand their circumstances and the range of choices they actually have right now. £400 plus £8 a day from not buying fags is enough to turn their lives around.

What could be more 'holistic' than money?

My point about responsibilities is that, and yes it's an opinion (if you aren't interested in other people's why are you on a forum?) is that the ability to carry a child should impact a mother's sense of responsibility. If that makes me a misogynist then fine. I'd rather be that than responsible for harm to an unborn child.

Here you are saying that because I have the ability to carry a child, I should be responsible for any child who may come to be conceived inside me.

I'm sorry but I don't think I have to conform to your idea of responsibility in order to have dominion over my own body, as you seemed to suggest up thread.

I may have the opinion that I find home births entirely irresponsible to put the child through possible unnessecery risk but that does not give me the right to dictate what the female must do with her own body.

And thats what we are talking about with smoking isn't it? Its possible unnessecery risk and it is the choice of the female if she wishes to smoke or not during pregnancy.

In order for a woman to ensure that ALL unnessecery risks such as obesity, smoking, alcohol, diet, carbon monoxide, hot baths, and special needs/ disability are to be minimised, you are effectively dictating that all fertile woman of childbearing age should be slim, active, not smoke, not drink, eat healthily, stay away from cars, never take hot baths, use jacuzzis, take supplements every morning and basically not have sex over 40 as the risk of creating a baby with down syndrome is just too high. That way all babies from the day the sperm hits the egg (because they are already unborn humans before we POAS) will be protected from the selfish risk taking mothers and all will be well in the world according to MRSC

Wow a lot of posts!

Jassy I think they are going in the right direction slowly. I agree they still need more progress but I don't agree paying people to do it is the right approach.

Plenty, while it might work during the pregnancy I don't believe it would long term. A lot of people in this situation are surrounded by partners and friends who smoke. Also if you are unfortunate enough to be caught in the poverty trap then when the incentive comes to an end if nothing else in your life has changed then you fall back into the same routines.

Hamilitoes I don't believe we should legislate what women do with their bodies in general so in that sense I agree with bodily autonomy however at the same time I don't think, as a taxpayer, I should pay someone to make good choices.

As for the feminist argument it is simply my own view that there are far more important fights than women seriously arguing their 'right' to harm a child in utero. For one thing, congratulations, it already exists so the fight is kind of won.

Read my Ppost. If we are placing the risk of an unborn child being affected above the choices of the pregnant female then we are effectively saying that a fertile woman cannot do any of the things listed above, as there is always a risk to a child in its first 4-6 weeks of development.

Its not about their right to harm a child in the utero, its about their right to choose what risks they do and do not take with their own bodies while carrying said child (or indeed TTC, or being sexually active as no contraception is 100%)

How is that NOT a feminist issue in 21st Century Britain?? Its an issue for every woman alive! And I wouldn't even class myself as a feminist!!

But again we already have that right so how is it an issue? That's what I don't get. Women have that right already so why is something we have to 'fight' for?

Again I don't think the law should be changed but I don't think its fair to have to pay women to make good choices.

So the answer is - keep doing what we're doing, and bad luck babies (and mothers) we could have helped with something that, based on evidence, leads to be better outcomes.

Lovely. How moral.

Even if the woman starts smoking again after the baby's born, it's still good for the baby's health. Smoking affects the baby more when it's in-utero.

And going back to the how can we justify the cost argument - smoking increases the risk of premature birth. Risk increases the more a woman smokes. According to NICE, for neo-natal care in (2008-09), the typical daily cost of special care was £476, high dependency was £759, intensive care was £1081. It's not at all unusual for a premature baby to need at least a short stay in a special care unit. Extremely premature babies can be in hospital for months before they're well enough to be discharged.

My DS1 was 6 weeks early, had a 3 and a half week stay in special care (I'm a lifelong non smoker before you ask), and going by the above figures, he'll have cost the NHS over £11,000 before he was a month old.

Looking at it for a purely cold blooded financial point of view, if you can significantly reduce the need for that kind of hospital stay by handing out a few shopping vouchers, the NHS could make fantastic savings (that could then be spent on cancer drugs or any number of other worthy causes).

I agree that it's a feminist issue if the rights of the unborn baby are placed above the rights and choices of the pregnant women.

I'm aware that this isn't so much of a problem in the UK at the minute, but I've heard of recent cases globally where women have been prosecuted and imprisoned because they've been blamed for causing the death of their unborn baby. There was also that recent case in Ireland where a woman died as a result of pregnancy complications after doctors refused to abort the unborn baby that the woman was in the process of miscarrying.

There was also a recent case in the news where a local council in the UK was trying to get a child affected by foetal alcohol syndrome declared a victim of crime, which is the sort of thing that could lead us down a slippery slope where mothers are criminalized if their choices in pregnancy are deemed to have harmed their unborn child.

So definitely a feminist issue IMO. I'm really struggling to see how it can be perceived as irrelevant to feminism.

So the answer is - keep doing what we're doing, and bad luck babies (and mothers) we could have helped with something that, based on evidence, leads to be better outcomes.

Lovely. How moral.

Well, I'm just going to ask this once more in case Jassy or anyone else is interested in answering. Would you also like to offer financial incentives around overeating, given that the NHS is straining to cope with obesity? You could make a case for overweight pregnant women, overweight families with small children, overweight people without families, I'm pretty sure they'd all be cost-effective.

I don't see this as a feminist issue - rather, I fundamentally disagree with the state bribing its citizens to make good choices.

Goodbye, I've answered that a number of times, as have others in this thread. How wearisome.

There have been quasi-financial incentives on the NHS for ages and last year an employer-led strategy was announced.

But I've answered numerous questions on wider behavioral economics, including idiotic statements about paying thieves not to steal. My position again (yawn): where the research has been done and there is clear benefit to the individual and the state to deal with an addiction or addictive behaviour, then I think it's worth exploring. These moral high horses we're all so fond of can get awfully expensive and ultimately be a drain on the state.

As I've also said, this one -where there has been a trial, and the trial had better outcomes for two individuals seems like those who can pat themselves on the back for their moral superiority in not having an addiction when they got pregnant might just be able to hold their noses and say 'I don't like it, but those babies deserve a chance, even if I despise the mothers.'

Jassy, this is what you actually said.

The NHS already pays for people to attend weightloss groups and gives discounted personal training or gym sessions to help people with obesity - again because the potential benefit to the NHS (and to the individual) outweighs the cost.

That's a bit different than a shopping voucher, isn't it? That's analogous to sending a pregnant woman to stop-smoking sessions, which is not at all what this thread is about - is it?

My point about paying thieves not to steal was in response to your comment

If it's a net benefit, what's the problem, except that you think it should happen without the incentive? The fact is that it's happening without the incentive, and the incentive makes a difference. You don't need to feel warm and fuzzy about it to make it rational and beneficial.

If it makes you feel smarter to consider my reasons for objecting to this scheme idiotic, then by all means do. As I said before, I haven't heard one measured response to them.

Goodbye - so arguments about the scheme saving the NHS money and improving the health of mother and baby are irrelevant because they don't address whether it should be considered acceptable for "the state bribing its citizens to make good choices" ?

OK,others had already dealt with other incentives including vouchers on the NHS. I thought I had too so apologies.

As for theft - really? I thought you were being deliberately hyperbolic. There is a glaring difference between a behavioral issue with chemical or psychological triggers (smoking, overeating) and theft. You want to go into the reasons people steal and have a debates about how to reduce them? Great. For some, there is evidence (I know, I'm fucking boring banging on about evidence) that some people steal to fund drug addictions. So drug treatment programmes (which ad other have said can include behavioral incentives) can help to reduce revisionism.

But then, criminal sanctions are themselves a form of behavioural modifier.

But then, I didn't think you were really trying to draw a direct parallel between reducing theft and providing the most effective support to people hooked on one of the most addictive substances in existence, in a way that provides net health and financial benefits all round.

Live and learn.

That's pretty much the sum of my position, Shadow. To underscore my point, I explained (unsuccessfully, it seems) that there are any number of behaviors that the NHS could bribe people into discontinuing - it's a slippery slope.

Whatever the tactical calculations are in support of this scheme, they are outweighed by the strategic implications of an expanding welfare state and its increasingly dependent citizens.

How disconcerting is it that the government should pay someone to behave sensibly? These babies, in order to overcome the statistical odds stacked against them (I recognize that there are exceptions to this, even on this very thread, and I further expect that this disclaimer will be ignored all who disagree) would require a raft of further incentives to persuade their parents to behave sensibly. What happens in utero is merely the tip of the iceberg.

Whatever the tactical calculations are in support of this scheme, they are outweighed by the strategic implications of an expanding welfare state and its increasingly dependent citizens.

That's an interesting point. But isn't there an argument that it could actually reduce long term reliance on the welfare state (in the form of demands on the NHS)?

Do you have any evidence for your last paragraph, giving the vast numbers of children we are talking about? Is there evidence that nicotine addiction leads to parenting problems, outwith the underlying demographic issues? It's quite a strong statement, it would be interesting to see the basis of it.

But even if there is, then there are many, many state interventions for children once they are no longer biologically dependent on their mothers. Some work better than others.

But isn't there an argument that it could actually reduce long term reliance on the welfare state (in the form of demands on the NHS)?

I'd have to know what the rates of success were in order to make any judgement on that - if say, 20% of women were able to permanently give up smoking, than my philosophical view on this might yield to my practical view.

I don't have any evidence to suggest that these children are at a disadvantage other than two compelling data points: 1. Their mothers are pregnant smokers 2. They are almost certainly struggling financially (otherwise the incentive is diluted). Again, there will be exceptions but these children are statistically at risk, and they will be the ones on the receiving end of such incentive schemes.

At first glance I agree this scheme looks shit and depressing. It remindsne me of when I was a kid, and my sister was forever getting bribes, treats and rewards that I didn't get because I was good/ tidy/ reliable anyway. I think unfairness can really piss people off, and I understand why.

Having said that, this is one of those cases where you just have to look harder, and to accept that smoking is an irrational behaviour. The outcomes speak for themselves, and have knock on positive benefits that outweight the initial cost many times over.

The smokers I know don't see fag money as real money. But if you handed them a crisp tenner and said don't smoke today, that would give them pause for thought. The savings of not smoking would be an incentive to any objective mind, but smoking just isn't like that.

Looking at it for a purely cold blooded financial point of view, if you can significantly reduce the need for that kind of hospital stay by handing out a few shopping vouchers, the NHS could make fantastic savings (that could then be spent on cancer drugs or any number of other worthy causes).

Nope, thats the moral view imo. Looking at it from a purely cold blooded financial view, the gov would not be encouraging smokers to quit because well, they pay a shit tonne of tax to the UK treasury and statistically die younger.

If they really wanted smokers to quit they'd give them all an e-cigarette, american journal of preventative medicine study shows a quit rate of 34% after 6 months, 70% if the ecigarette was used more than 20 times a day. Compare that with the measly 7% of nicotine gum and 8.2% for patches which is the NHS stance.

They would at least provide funding for more research into this method if they really wanted people to quit.

I'd have to know what the rates of success were in order to make any judgement on that - if say, 20% of women were able to permanently give up smoking, than my philosophical view on this might yield to my practical view.

Well, you won't know that for some time. But given that the success rates quoted lasted beyond pregnancy, it will be interesting to see another year or so down the track. What are the general rates for relapse among those who have stopped smoking for a year? That would be a reasonable proxy.

I don't have any evidence to suggest that these children are at a disadvantage other than two compelling data points: 1. Their mothers are pregnant smokers 2. They are almost certainly struggling financially (otherwise the incentive is diluted). Again, there will be exceptions but these children are statistically at risk, and they will be the ones on the receiving end of such incentive schemes.

Hell, £400 in vouchers is something of find attractive and I'm undeniably well-off.

You say 'these children' (10-20% of kids) are statistically at risk after birth - under what statistics? Are you talking about smoking only, or more broadly?

If smoking only - it seems even more sensible in that case to try to break the cycle any way we can.

Likewise, 400 in vouchers is attractive to me. Would I give up an addiction in exchange for them? In a word, no.

I have a diet coke addiction (I gave it up for 2 months but relapsed last week over a sore throat of all things).

The joy that diet coke brings me outstrips the joy that the vouchers would bring me by a substantial margin, it's not remotely a contender. My heath and the health of my teeth is something I can't reliably spend my way out of, so this is a greater incentive.

If I were poor, this calculus would change entirely.

You say 'these children' (10-20% of kids) are statistically at risk after birth - under what statistics? Are you talking about smoking only, or more broadly?

I'm not googling this. It stands to reason that children who are born into low-income homes to smoking mothers are at risk; not causal but rather a constellation of factors. I've made assumptions, just as bureaucrats do when they're formulating these kinds of programs.

Bureaucrats don't make sweeping assumptions, nor do they say things are 'statistical' when they mean 'my gut says'. They commission research. They look at actual statistics. They do pilots to see what works.

They are also aware that behavioral science, including around both motivations and around human perception and processing of risk, is a tiny bit more complex than you are presenting it in your diet coke analogy.

What chemical in diet coke are you addicted to?

Fair point, Hamiltoes.

I was momentarily forgetting about the taxes on cigarettes. There's still an argument to be made that most smokers will have paid out enough money in cigarette taxes to cover the cost of the shopping vouchers.

Oh I definitely agree on that, which is why i'm of the opinion that if they want to try to quit cold turkey using the vouchers then good luck to them. A 20 a day cigarette habit would cover the £400 in vouchers 6 times over in a 1 year. Almost like a mini tax rebate.

But, that doesn't mean I think we should be forcing women to quit smoking and fining them if they choose to take the risk as some PPs have suggested. They should just have all the options they need/ want should they choose to quit.