Financial Incentives Alone Versus Incentivized Partner Support for Promoting Smoking Cessation During Pregnancy and Postpartum:Protocol for a Non-Randomized Single-Blinded Study

Background: Smoking tobacco remains the most significant modifiable cause of adverse pregnancy outcomes and contributorto ongoing maternal and infant ill-health. Pregnancy for many is a time of heightened health focus, with the primary motivationbeing the well-being of the unborn child. Yet, many women continue to smoke throughout their pregnancy. Despite this heightenedmotivation and known health risks, interventions to date have not effectively curbed the rate of smoking during pregnancy andthey remain as high as rates among the general population. One promising strategy has been to incentivize these women to quit.However, incentives-based studies have not shown or reported long-term efficacy. Here, we present the protocol of a trial exploringthe effect of incentivized partner support on pre- and postpartum smoking cessation.Objective: The aim of this study is to determine whether providing incentives to both the expectant mother and her supportperson in promoting short- and long-term smoking cessation during pregnancy is more effective than incentives to the expectantmother alone.Methods: This protocol is designed as a non-randomized, single-blinded trial to determine the efficacy of incentivized partnersupport, compared to participant incentive only, in promoting smoking cessation during pregnancy and postpartum. All eligiblepregnant women receiving antenatal care via the Tasmanian Health Service (Australia) will be invited to participate. Participantswill be eligible for monthly quit-contingent shopping vouchers if they verify, via carbon monoxide breath sample, as beingabstinent from smoking. Participating women will be eligible for vouchers until 6-months postpartum and will be followed up at12-months postpartum.Results: The recruitment phase of this study has concluded. Results are expected to be published by the end of 2018.Conclusions: This study protocol extends the current literature on incentivized smoking cessation interventions for pregnantwomen by assessing the influence of incentivizing a support partner on short- and long-term abstinence. Key ethical considerationsare discussed including potential for receipt (or not) of quit-contingent vouchers impacting negatively on the participant’srelationship with their partner. The findings of the study may have important implications for the role support partners are assignedin smoking cessation programs targeting pregnant women