“Money doesn't mean anything to me”: How a financial incentive for tobacco smoking cessation is experienced by women in pregnancy
1
School of Public Health, Adelaide University, Adelaide, Australia
2
School of Medicine and Adelaide Rural Clinical School, Adelaide University, Adelaide, Australia
3
Robinson Research Institute, Adelaide, Australia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Financial incentives have been used to promote smoking cessation in pregnancy. While there has been some success with incentives, there is limited understanding of women’s perception and experience of being offered an incentive for behaviour-change.
METHODS:
Twelve pregnant women who smoked tobacco were recruited from an place hospital. They were offered a $100 gift-card for 4-weeks smoking abstinence, verified by carbon monoxide monitor. Two interviews were conducted, at the beginning and end of the 4-week period. Interviews were audio-recorded, transcribed and thematically analysed against behaviour change models considering, but not limited to, motivation, intention, control and self-efficacy.
RESULTS:
The financial incentive for smoking cessation was ineffective for eleven (92%) participants. Four qualitative themes were generated where women described: 1) initial optimism but with trepidation about committing to success, 2) the ‘use-value’ of smoking in pregnancy within their caring roles, while devaluing the significance of money, 3) having limited control over their smoking behaviour that lead to decreased self-efficacy and disempowerment, culminating in stress, anxiety and shame, and 4) feeling devalued and lacking autonomous motivation required for successful cessation.
CONCLUSIONS:
Trials offering financial incentives for smoking cessation in pregnancy have reported challenges with recruitment and ‘lack of involvement’ of the target population. Thus, the perspectives here provide a valuable foundation for understanding the experience of participants for whom a financial incentive is ineffective, as well as those who may be reluctant to engage with the intervention at all.
Financial incentives have been used to promote smoking cessation in pregnancy. While there has been some success with incentives, there is limited understanding of women’s perception and experience of being offered an incentive for behaviour-change.
METHODS:
Twelve pregnant women who smoked tobacco were recruited from an place hospital. They were offered a $100 gift-card for 4-weeks smoking abstinence, verified by carbon monoxide monitor. Two interviews were conducted, at the beginning and end of the 4-week period. Interviews were audio-recorded, transcribed and thematically analysed against behaviour change models considering, but not limited to, motivation, intention, control and self-efficacy.
RESULTS:
The financial incentive for smoking cessation was ineffective for eleven (92%) participants. Four qualitative themes were generated where women described: 1) initial optimism but with trepidation about committing to success, 2) the ‘use-value’ of smoking in pregnancy within their caring roles, while devaluing the significance of money, 3) having limited control over their smoking behaviour that lead to decreased self-efficacy and disempowerment, culminating in stress, anxiety and shame, and 4) feeling devalued and lacking autonomous motivation required for successful cessation.
CONCLUSIONS:
Trials offering financial incentives for smoking cessation in pregnancy have reported challenges with recruitment and ‘lack of involvement’ of the target population. Thus, the perspectives here provide a valuable foundation for understanding the experience of participants for whom a financial incentive is ineffective, as well as those who may be reluctant to engage with the intervention at all.
| eISSN: | 2654-1459 |
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