title: Improving Public Acceptability of Using Financial Incentives for Smoking Cessation During Pregnancy: A Randomized Controlled Experiment.
abstract: BACKGROUND
  Financial incentives are effective for smoking cessation during pregnancy. Public opinion is important for successful dissemination of this approach from research into clinical practice. We developed a brief information-based intervention to improve public acceptability.
  
  
  METHODS
  We recruited 166 adult participants (54.2% females [6.7% pregnant], 25.3% smokers, mean age 32.4 years [SD, 9.9]) currently living the United States from Amazon Mechanical Turk. They were randomized to either intervention (N = 84) or control (N = 82). The control group read educational materials on car safety for pregnant women and young children. The intervention group read educational materials on the rationale behind using financial incentives for smoking cessation during pregnancy. Key outcomes were 11 opinion items regarding whether using financial incentives to help pregnant smokers to quit is a good idea; its effectiveness, fairness, cost, health benefits, and saved healthcare cost; and pregnant women's responsibility and difficulty of quitting smoking.
  
  
  RESULTS
  Intervention and control groups had similar pretest opinion on using financial incentives for smoking cessation during pregnancy. All 11 mean opinion scores significantly increased in the intervention group, but remained stable in the control group. After the intervention, 27.7% more of participants (from 62.6% to 90.3%; P value < .001) in the intervention group and only 4.8% more (from 64.6% to 69.4%; P value = .557) in the control group agreed that "Paying pregnant women who smoke to quit smoking is a good idea" (interaction P value = .015).
  
  
  CONCLUSIONS
  Our low-cost information-based intervention has the potential to improve public acceptability of this efficacious approach to promoting smoking cessation during pregnancy.
  
  
  CONCLUSIONS
  In this sample of educated young adults, our low-cost information-based intervention substantially improved their acceptability of using financial incentives for smoking cessation during pregnancy. Our intervention can be used to gain public support before implementing this approach as a policy in the general population. One potential concern that needs to be further addressed by future intervention is unfairness of this smoking cessation approach to pregnant nonsmokers.
authors.affiliation: Division of Behavioral Medicine, Department of Pediatrics, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY; xiaozhongwen@hotmail.com.
authors.forename: Xiaozhong
authors.initials: X
authors.lastname: Wen
authors.affiliation: Vermont Center on Behavior and Health, Departments of Psychiatry and Psychology, University of Vermont, Burlington, VT.
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Higgins
authors.affiliation: Division of Behavioral Medicine, Department of Pediatrics, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY;
authors.forename: Chuanbo
authors.initials: C
authors.lastname: Xie
authors.affiliation: Division of Behavioral Medicine, Department of Pediatrics, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY;
authors.forename: Leonard H
authors.initials: LH
authors.lastname: Epstein
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011639:Public Opinion; D016540:Smoking Cessation / Q000191:economics / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D014029:Tobacco Use Disorder / Q000628:therapy*; D014481:United States; D055815:Young Adult