Public acceptability of financial incentives for smoking cessation in pregnancy and breastfeeding (Meeting Abstract)

Introduction. Financial incentives are being promoted for lifestyle behaviour change, but are controversial. We surveyed public attitudes about incentives for smoking cessation and breastfeeding in the UK as part of a mixed methods study to inform incentive trial design. Methods. Seven promising incentive strategies were identified from evidence syntheses and qualitative interview data: (i) validated smoking cessation in pregnancy and (ii) after birth; (iii) for a smoke-free home; (iv) for proven breastfeeding; (v) a free breast pump; (vi) payments to health services for reaching smoking cessation in pregnancy targets and (vii) breastfeeding targets. We used area quota sampling, home-administered computer-assisted questionnaires, agreement measured on a 5 point scale and multivariable ordered logit models. Results. Amongst 1144 UK adults agreement with incentives was mixed (ranging from 34-46%). Mean agreement score was highest for a free breast pump; and lowest for incentives for smoking abstinence after birth. More women than men disagreed with shopping vouchers. 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 incentives compared to those aged 65 and over, particularly provider targets for smoking cessation. Non-white ethnic groups agreed particularly with breastfeeding incentives. Current smokers and respondents with breastfed children agreed with providing vouchers for the respective behaviours. Up to £40 per month vouchers were acceptable (>85%). Conclusion.Women and the less educated aremore likely to disagree, but those of child-bearing age to agree, with incentives which are designed for their benefit.