Smoking contributes to higher rates of miscarriage,
premature births, difficulties during childbirth and sudden
infant death syndrome. Photo / Getty Images
Women smokers are being offered vouchers for up to $300
if they quit while pregnant, because of the damage a mother's
tobacco use can do to an unborn baby.
The voucher scheme in South Auckland, for groceries, baby
products, phone credit, cinema tickets or petrol, is among
the latest additions to the Government's arsenal of
quit-smoking schemes in which the main weapon is a four-year
programme of annual 10 per cent tobacco tax rises.
The second of those - more than 11 per cent, including an
inflation-linked boost - took effect yesterday.
British American Tobacco says the recommended retail price of
its Holiday King Size cigarettes is now $18 for a packet of
20, up from $16.20.
Some experts have questioned whether incentives are effective
in breaking habits, but the team behind this scheme says
overseas trials have shown that incentives can motivate
quitting by pregnant women who are finding it hard to stop.
Because of the persistently high rate of smoking among
pregnant Maori women, researchers are looking for new ways to
help them quit.
Smoking is declining and in the latest national survey last
year, 15.5 per cent of adults of all ethnicities smoked
daily. For Maori the figure was far higher, at 36 per cent.
Earlier research found that 44 per cent of pregnant Maori
women were smoking when they registered with a midwife and
that this had dropped to 34 per cent when discharged from the
midwife's care. For Pakeha, the rate went from 13 per cent,
Smoking during pregnancy contributes to higher rates of
miscarriage, pre-term births, low-birth-weight babies'
difficulties during childbirth, sudden infant death syndrome,
asthma and glue ear.
Auckland University tobacco control expert Dr Marewa Glover
said the affected children, especially girls, were at greater
risk of taking up smoking themselves.
The Counties Manukau District Health Board is giving vouchers
at one week, four, eight and 12 weeks after a woman's
quit-smoking date if she remains smokefree, verified by tests
on a machine that measures carbon monoxide.
The vouchers are offered to Maori and Pacific women up to 28
weeks pregnant who live in Manurewa, where the DHB says there
are around 370 "smoke-exposed" births a year.
They cannot be exchanged for cash, alcohol or tobacco.
The DHB says the benefits of preventing smoking-related birth
complications far outweigh the maximum voucher cost of $300
cost for each woman. "By comparison, a 24-hour period of care
for a premature baby costs up to $3000."
The vouchers are given to the women along with routine care,
such as nicotine replacement therapy and face-to-face or
A review of 19 studies of quit-smoking competitions and
rewards, published by the international Cochrane Library in
2011, concluded that "smokers may quit while they take part
in a competition or receive rewards for quitting, but
generally do no better than unassisted quitters once the
Smoking behaviour expert Professor Janet Hoek, of Otago
University, said of the voucher scheme: "Anything is worth
trying because we know smoking during pregnancy is harmful to
the mother and particularly the unborn child. Good on them
for giving this a go."
She said it would be preferable to make the rewards available
for as long as possible during pregnancy.
"If you can get women early and keep applying rewards over an
extended period you have the best probability of behaviour
Theresa Marteau, professor of health psychology at Kings
College, London, reviewed research on financial incentives in
a study published in the British Medical Journal in 2009.
"The theory is that much of our behaviour - 45 per cent - is
habitual," she said.
"The idea of incentives is to help break bad habits and, once
the new habit is established, the incentive can be removed.
But unless you change the environment, the chances of success
Dr Glover's group is trialling another approach called "the
Aunties": Maori women find pregnant women through their
community networks and urge and support them to quit smoking
- and to register with a midwife.
Baby 'enough of a reward'
Jocelyn Hira quit smoking during pregnancy for the sake of
her baby Lincoln's health and she doesn't think the incentive
of $300 worth of vouchers should be necessary.
She says carrying a baby should be incentive enough for
pregnant women to stop smoking.
"If you are mature enough to have a child, you are mature
enough to make the right decision."
Mrs Hira, 40, of Pukekohe, has a son aged 23, and
She was 18 weeks pregnant with Lincoln when she learned she
was carrying a baby.
"I knew I needed to give up, especially while I was pregnant.
Within the first two weeks of finding out I was pregnant I
knocked it on the head."
She shunned nicotine replacement therapy or other aids,
relying only on food, especially sweets, as a "replacement".
Since Lincoln's birth, Mrs Hira has resumed smoking - up to
two cigarettes a day - but she regrets this and "fights the