Pregnant women could be given shopping vouchers worth up to £400 to quit smoking under new guidance for the NHS.
The National Institute for Health and Care Excellence (Nice) and Public Health England said evidence shows that offering financial incentives to help pregnant women stop smoking is “both effective and cost effective”.
Their guidance, which is open to consultation, said studies have shown “voucher incentives were acceptable to many pregnant women and healthcare providers” and are already in use in some regions.
The experts said women should undergo biochemical tests to prove they have stopped smoking before receiving the vouchers.
However they said that if testing is too difficult due to the Covid-19 pandemic, the vouchers should be given anyway.
The guidance, which kicks in when women are referred to an NHS Stop Smoking Service or those run by bodies such as councils, public health teams and charities, said: “Evidence from the UK showed that schemes in which a maximum of around £400 could be gained in vouchers staggered over time (with reductions for each relapse made) were effective and cost effective.”
Research suggests that for every 1,000 pregnant women offered vouchers, 177 would stop smoking.
The new guidance also said healthcare staff should give clear and up-to-date information on e-cigarettes to people who are interested in using them to stop smoking, but should stress the long-term health effects of them are still uncertain.
It argued that nicotine-containing e-cigarettes have been shown to help people stop smoking and are similarly effective to other stop-smoking interventions such as nicotine replacement therapy.
No nicotine e-cigarettes are currently available on the NHS.
Dr Paul Chrisp, director of Nice’s centre for guidelines, said: “These draft guideline recommendations are a renewed effort to reduce the health burden of smoking and to encourage and support people to give up smoking.
“Smoking continues to take a huge toll on the health of the nation and accounts for approximately half the difference in life expectancy between the richest and poorest in society. It is therefore vitally important that we reduce the level of smoking in this country.
“We know that around 10% of women are known to be smokers at the time of giving birth and, given the significant health effects of smoking on both mothers and babies, it is clear that further efforts are required to encourage this group to give up smoking.
“We need to use every tool in our arsenal to reduce smoking rates, including education, behavioural support, financial incentives, and e-cigarettes if people are interested in using them.
“Combined, we hope that people who smoke will feel enabled to give up tobacco products once and for all.”
Dr Jamie Hartmann-Boyce, senior research fellow in health behaviours at the University of Oxford, welcomed the guidance, adding: “A growing body of evidence suggests that e-cigarettes are considerably less harmful than smoking – though not risk-free – and can help people quit smoking.
“Evidence supports providing vouchers to help pregnant people quit smoking, and it is great to see this in the new draft guidance.
“Studies of this type of programme show that people remained smoke-free even after the vouchers or other types of rewards finished.
“Evidence shows these programmes also work outside of pregnancy. It would be positive to see them used across a range of contexts.”