title: Public acceptability of financial incentives for smoking cessation in pregnancy and breast feeding: a survey of the British public.
abstract: OBJECTIVE
  To survey public attitudes about incentives for smoking cessation in pregnancy and for breast feeding to inform trial design.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  British general public.
  
  
  METHODS
  Seven promising incentive strategies had been identified from evidence syntheses and qualitative interview data from service users and providers. These were shopping vouchers for: (1) validated smoking cessation in pregnancy and (2) after birth; (3) for a smoke-free home; (4) for proven breast feeding; (5) a free breast pump; (6) payments to health services for reaching smoking cessation in pregnancy targets and (7) breastfeeding targets. Ipsos MORI used area quota sampling and home-administered computer-assisted questionnaires, with randomised question order to assess agreement with different incentives (measured on a five-point scale). Demographic data and target behaviour experience were recorded. Analysis used multivariable ordered logit models.
  
  
  RESULTS
  Agreement with incentives was mixed (ranging from 34% to 46%) among a representative sample of 1144 British adults. Mean agreement score was highest for a free breast pump, and lowest for incentives for smoking abstinence after birth. More women disagreed with shopping vouchers than men. Those with lower levels of education disagreed more with smoking cessation incentives and a breast pump. Those aged 44 or under agreed more with all incentive strategies compared with those aged 65 and over, particularly provider targets for smoking cessation. Non-white ethnic groups agreed particularly with breastfeeding incentives. Current smokers with previous stop attempts and respondents who had breast fed children agreed with providing vouchers for the respective behaviours. Up to £40/month vouchers for behaviour change were acceptable (>85%).
  
  
  CONCLUSIONS
  Women and the less educated were more likely to disagree, but men and women of childbearing age to agree, with incentives designed for their benefit. Trials evaluating reach, impact on health inequalities and ethnic groups are required prior to implementing incentive interventions.
  
  
  BACKGROUND
  CRD42012001980.
authors.affiliation: Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK.
authors.forename: Pat
authors.initials: P
authors.lastname: Hoddinott
authors.affiliation: Health Services Research Unit, University of Aberdeen, Aberdeen, UK.
authors.forename: Heather
authors.initials: H
authors.lastname: Morgan
authors.affiliation: Health Services Research Unit, University of Aberdeen, Aberdeen, UK.
authors.forename: Graeme
authors.initials: G
authors.lastname: MacLennan
authors.affiliation: Ipsos MORI Scotland, Edinburgh, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Sewel
authors.affiliation: Maternal and Infant Nutrition and Nurture Unit, University of Central Lancashire, Preston, UK.
authors.forename: Gill
authors.initials: G
authors.lastname: Thomson
authors.affiliation: Health Policy and Social Marketing, University of Stirling, Stirling, UK.
authors.forename: Linda
authors.initials: L
authors.lastname: Bauld
authors.affiliation: Health Economics Research Unit, University of Aberdeen, Aberdeen, UK.
authors.forename: Deokhee
authors.identifier: http://orcid.org/0000-0003-4894-1689
authors.initials: D
authors.lastname: Yi
authors.affiliation: Health Economics Research Unit, University of Aberdeen, Aberdeen, UK.
authors.forename: Anne
authors.initials: A
authors.lastname: Ludbrook
authors.affiliation: Health Services Research Unit, University of Aberdeen, Aberdeen, UK.
authors.forename: Marion K
authors.initials: MK
authors.lastname: Campbell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001942:Breast Feeding; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008425:Maternal Behavior; D008875:Middle Aged; D009042:Motivation; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D016540:Smoking Cessation / Q000191:economics*; D011795:Surveys and Questionnaires; D006113:United Kingdom; D055815:Young Adult
keywords: PUblic Health; Preventive Medicine; Social Medicine