Background
Methods
Intervention design
Outcome evaluation
Process evaluation
Results
Outcome evaluation
Participant characteristics
NHS Tayside | Area 1 (A1) | Area 2 (A2) | Area 3 (A3) | Pairwise comparisons$
| |||
---|---|---|---|---|---|---|---|
A1 vs. A3
|
A1 vs. A2
|
A3 vs. A2
| |||||
N | 393(100) | 160(40.7) | 144(36.6) | 89(22.7) | 0.2041 | 0.7607 | 0.3600 |
Mean age: years (SD) | 27.2(6.2) | 26.7(6.1) | 26.9(6.6) | 27.7(5.8) | |||
Age groups(years):
| |||||||
<20 | 55(14.0) | 26(16.3) | 21(14.6) | 8(9.0) | |||
≥20 - <25 | 110(28.0) | 41(25.6) | 42(29.2) | 27(30.3) | |||
≥25 - <30 | 101(25.7) | 42(26.3) | 39(27.1) | 20(22.5) | |||
≥30 - <40 | 117(29.8) | 49(30.6) | 36(25.0) | 32(36.0) | |||
≥40 | 10 (2.5) | 2(1.3) | 6(1.5) | 2(2.3) | 0.4261 | 0.4321 | 0.3169 |
SIMD quintile*:
| |||||||
1 (most deprived) | 142(37.2) | 108(67.9) | 22(16.1) | 12(14.0) | |||
2 | 115(30.1) | 26(16.4) | 57(41.6) | 32(37.2) | |||
3 | 61(16.0) | 7(4.4) | 24(17.5) | 30(34.9) | |||
4 | 41(10.7) | 9(5.7) | 27(19.7) | 5(5.8) | |||
5 (least deprived) | 23(6.0) | 9(5.7) | 7(5.1) | 7(8.1) |
<0.0001
|
<0.0001
|
0.0050
|
Paid employment:
| |||||||
Yes | 176(44.8) | 71(44.4) | 67(46.5) | 38(42.7) | |||
No | 149(37.9) | 59(36.9) | 60(41.7) | 30(33.7) | |||
Missing | 68(17.3) | 30(18.8) | 17(11.8) | 21(23.6) | 0.6528 | 0.2362 | 0.0559 |
How many cigarettes smoked per day:
| |||||||
Less than 10 | 101(25.7) | 2(26.3) | 43(29.9) | 16(18.0) | |||
11-20 | 170(43.3) | 65(40.6) | 66(45.8) | 39(43.8) | |||
20+ | 55(14.0) | 24(15.0) | 18(12.5) | 13(14.6) | |||
Missing | 67(17.1) | 29(18.1) | 17(11.8) | 21(23.6) | 0.4439 | 0.3656 |
0.0462
|
How long before first cigarette in the morning:
| |||||||
Within 5 minutes | 126(32.1) | 56(35.0) | 40(27.8) | 30(33.7) | |||
6 - 30 minutes | 96(24.4) | 39(24.4) | 35(24.3) | 22(24.7) | |||
31-60 minutes | 50(12.7) | 14(8.8) | 28(19.4) | 8(9.0) | |||
After 1 hour | 51(13.0) | 22(13.8) | 23(16.0) | 6(6.7) | |||
Missing | 70(17.8) | 29(18.1) | 18(12.5) | 23(25.8) | 0.3844 | 0.0534 |
0.0077
|
How many quit attempts in last year:
| |||||||
None | 141(35.9) | 56(35.0) | 56(38.9) | 29(32.6) | |||
One | 107(27.2) | 42(26.3) | 43(29.9) | 22(24.7) | |||
2+ | 71(18.1) | 33(20.6) | 25(17.4) | 13(14.6) | |||
Missing | 74(18.8) | 29(18.1) | 20(13.9) | 25(28.1) | 0.2736 | 0.5867 | 0.0682 |
Quit rates
NHS Tayside | Area 1(A1) | Area 2(A2) | Area 3(A3) | Pairwise comparisons$
| |||
---|---|---|---|---|---|---|---|
A1 vs.A3
|
A1 vs.A2
|
A3 vs.A2
| |||||
N | 393 | 160 | 144 | 89 | |||
4 week pass rate | 211(53.7) | 76(47.5) | 86(59.7) | 49(55.1) | 0.2531 |
0.0330
| 0.4833 |
12 week pass rate | 125(31.8) | 46(28.8) | 52(36.1) | 27(30.3) | 0.7920 | 0.1703 | 0.3657 |
3 month post partum pass rate | 65(16.5) | 25(15.6) | 31(21.5) | 9(10.1) | 0.2247 | 0.1850 |
0.0248
|
NHS Tayside | Area 1 (A1) | Area 2 (A2) | Area 3 (A3) | Pairwise comparisons$
| |||||||
---|---|---|---|---|---|---|---|---|---|---|---|
N | N(%) quit at | N | N(%) quit at | N | N(%) quit at | N | N(%) quit at | ||||
4 weeks | 4 weeks | 4 weeks | 4 weeks | ||||||||
N | 393 | 211(53.7) | 160 | 76(47.5) | 144 | 86(59.7) | 89 | 49(55.1) |
A1 vs. A2
|
A1 vs. A3
|
A3 vs. A2
|
SIMD quintile*:
| |||||||||||
1 (most deprived) | 142 | 66(46.5) | 108 | 49(45.4) | 22 | 11(50.0) | 12 | 6(50.0) | |||
2 | 115 | 64(55.7) | 26 | 15(57.7) | 57 | 33(57.9) | 32 | 16(50.0) | |||
3 | 61 | 35(57.4) | 7 | 2(28.6) | 24 | 13(54.2) | 30 | 20(66.7) | |||
4 | 41 | 28(68.3) | 9 | 5(55.6) | 27 | 20(74.1) | 5 | 3(60.0) | |||
5 (least deprived) | 23 | 12(52.2) | 9 | 4(44.4) | 7 | 5(71.4) | 7 | 3(42.9) |
<0.0001
|
<0.0001
|
0.0074
|
Paid employment:
| |||||||||||
Yes | 176 | 105(59.7) | 71 | 42(59.2) | 67 | 42(62.7) | 38 | 21(55.3) | |||
No | 149 | 72(48.3) | 59 | 20(33.9) | 60 | 36(60.0) | 30 | 16(53.3) | |||
Missing | 68 | 34(50.0) | 30 | 14(46.7) | 17 | 8(47.1) | 21 | 12(57.1) | 0.0604 | 0.3960 | 0.0554 |
Parameter | Locality | Number (% of population) | |
---|---|---|---|
1. | Number of Birthsa
| Area 1 | 1754 |
Area 2 | 1361 | ||
Area 3 | 1168 | ||
NHS Tayside | 4283 | ||
2. | Number of women smoking at first booking | Area 1 | 493 (28.1) |
with midwifery service | Area 2 | 269 (19.8) | |
(% of women who gave birth)b
| Area 3 | 299 (25.6) | |
NHS Tayside | 1061 (24.8) | ||
3. | Number of pregnant smokers who make a | Area1 | 65 (13.2) |
quit attempt with GIUFBc
| Area 2 | 74 (27.5) | |
(% population who smoke at first booking) | Area 3 | 71 (23.7) | |
CHPd Not Assigned | 3 | ||
NHS Tayside | 213 (20.1) | ||
4. | Number of pregnant smokers who | Area 1 | 27 (5.5) |
make a quit attempt and who are | Area 2 | 33 (12.3) | |
successful at 4 weeks | Area 3 | 20 (6.7) | |
(% population who smoke at first booking) | CHP Not Assigned | 3 | |
NHS Tayside | 83 (7.8) | ||
5. | Number of pregnant smokers who make a | Area 1 | 15 (3.0) |
quit attempt and are successful | Area 2 | 25 (9.3) | |
at 12 weeks | Area3 | 14 (4.7) | |
(% population who smoke at first booking) | CHP Not Assigned | 1 | |
NHS Tayside | 54 (5.1) | ||
6. | Number of pregnant smokers who make a | Area1 | 11 (2.2) |
quit attempt and are tobacco-free | Area 2 | 21 (7.8) | |
at delivery | Area 3 | 10 (3.3) | |
(% population who smoke at first booking) | NHS Tayside | 42 (4.0) |
Incentive payments
Process evaluation
Participant characteristics
Area | No. of participants | Attendance at a registered pharmacy | Average age | Family status | SIMD (V2) | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Quintile | ||||||||||||
(Scotland) | ||||||||||||
Frequent* | Infrequent** | 1stchild | 2 or more | Q1 | Q2 | Q3 | Q4 | Q5 | DK | |||
Area 1
| 10 | 5 | 5 | 28.4 years | 6 | 4 | 8 | 1 | 0 | 0 | 1 | 0 |
Area 2
| 10 | 6 | 4 | 23.0 years | 6 | 4 | 5 | 2 | 1 | 1 | 0 | 1 |
All
| 20 | 11 | 9 | 25.7 years | 12 | 8 | 13 | 3 | 1 | 1 | 1 | 1 |
Sources | Quotes |
---|---|
C6 (Area 2, Aged 31, 3rd Child, Quintile 1, Frequent attender) | I’d smoked through my previous pregnancies so this time I really, really wanted to give it a bash… |
C8 (Area 2, Aged 25, 1st Child, Quintile 2 Frequent attender) | Because I was carrying him, it was for his sake. If I wasn’t pregnant I wouldn’t have stopped, I would have found it really hard. |
C8 (Area 2, Aged 25, 1st Child, Quintile 2, Frequent attender) | I was going to do it regardless (of Give It Up For Baby) and it was because you are pregnant you would get free patches… To be honest I only used them (the free patches) for the first two weeks, I knew I didn’t want to harm him (…) But they said ‘well you have to take them, just in case’ – I’ve got boxes and boxes of them at home. I hated the smell of them. |
C7 (Area 2, Aged 24, 2nd child, Quintile 1, Frequent attender) | Nobody gets to smoke in here, not anymore. Before I was pregnant and that yeah, people got to smoke in the kitchen, but no, if somebody comes up now they go outside and smoke. |
C8 (Area 2, Aged 25, 1st Child, Quintile 2 Frequent attender) | We got loads of nappies, wipes, baby milk, things for him - baby gates and things like that. |
Sources | Quotes |
---|---|
C20 (Area 1, Aged 22, 1st Child, Quintile 2, Frequent attender) | Everybody was moaning at me so I thought okay, I’ll give it a go, but it didn’t really work. And my mum made a rule that I couldn’t smoke in the house, so I was going outside, which was really hard, but I did it. |
C9 (Area 2, Aged 17, 1st Child, Quintile unknown, Frequent attender) | I did like, I tried, but I think I could have tried harder, but like, I think it’s old wife’s tales, all this smoking stuff when you’re pregnant, because she came out at eight (pounds) and there was not one thing wrong with her either, she was a really healthy baby and I think they just over exaggerate, they’re mad on it. |
C10 (Area 2, Aged 20, 1st Child, Quintile 3, Infrequent attender) | Interviewer: Did the money figure at all in your thinking? |
Respondent: No, not at all really. I wasn’t bothered. I never got money at the end of it, but I got this voucher through and I was so shocked I even got it cos I thought you had to finish it before you got any money. I didn’t expect to get anything. It wouldn’t have made a big difference cos my mum and dad help me out a lot. They buy nappies every week. | |
C5 (Area 2, Aged 14, 1st child, Quintile 1, Infrequent attender) | It was my uncle, he was constantly going at me to give up and I just couldn't… I really do want to, but I just, I don't know how to. Anything I try, it doesn't seem to be working. |
C5 (Area 2, Aged 14, 1st child, Quintile 1, Infrequent attender) | Interviewer: What about the incentive, does that make any difference? |
Respondent: No, not really. Every week you go, you can change what you're on, you get a week to try it and if you don't like it, you can change it. So, I just did that and I just kept going and changing it and none of them helped me…. I started off with the inhalator, then I went to the patches and then the lozenges and then… | |
C20 (Area 1, Aged 22, 1st Child, Quintile 2, Frequent attender) | It would have been nice to have someone to speak to because there was nobody else stopping so nobody knew what I was feeling like…. My mum she never smoked in her life, so, she’s like, I can’t believe you’re still smoking, but she has no idea what it’s like to stop (…) If there had been a group of pregnant women and we were all totally in the same boat, that would have been okay. |
Sources | Quotes |
---|---|
C16 (Area 1, Aged 19, 1st child, Quintile 1, Infrequent attender) | My sister was pregnant at the same time as me and it was her that told me about it, eh… and said ‘you get money for stopping smoking, like on a card’, and I was like I might give that a go. |
C15 (Area 1, Aged 24, 2nd child, Quintile 1, Infrequent attender) | She was okay (the pharmacist), but I think at the same time when I did fall back and I said to her ‘I’ve had one extra than I’m supposed to have today.’ She was kind of like ‘oh no that’s just bad’, she wasn’t sort of sympathetic, if you like. So I just says to her ‘well when you stopped smoking did you not fall back and have one?’ And she said ‘yeah’ and I went ‘well don’t judge me! It was just an accident, a mistake.’ |
C16 (Area 1, Aged 19, 1st child, Quintile 1, Infrequent attender) | What was important to me was the money really. Cos it could have done so much. With being pregnant and struggling on Job Seekers Allowance with nae top up (…) The money was the thing that actually edged me towards it (the scheme). |
C16 (Area 1, Aged 19, 1st child, Quintile 1, Infrequent attender) | The idea sounded really good to me but then when I got the rush to have a fag I just totally forgot all about the money. I really did want to give up but…missing that fag, I think it just wasn’t strong enough. I truly did try and get – I hadn’t like the confidence to do it really. I just don’t think I had what it takes to do it. |
C19 (Area 1, Aged 33, 1st child, Quintile 1, Infrequent attender) | I did want to stop smoking and although I wasn’t really a heavy smoker I felt, well I could really do with the £12.50 a week for ASDA tokens that would really be good for me, because I was on benefits… I was on Incapacity Benefit for depression. I’d split up with his father so I was really on my own. I had no support, no money, but it just didn’t really work out all that great. |
Sources | Quotes |
---|---|
C1 (Area 2, Aged 22, 1st child, Quintile 1, Frequent attender) | I know myself I shouldn’t be smoking. If I do slip up and I smoke a fag then I feel so guilty. I’m like, I’m sorry baby and I feel so bad. It’s horrible. It is very difficult… |
It was really easy to cut down when I first started trying to stop. I didn’t find it difficult to cut down. It was going from a couple a day to completely stopping was the hard part. I’d cut down just as I started the scheme I was only on about three or four a day… | |
C3 (Area 2, Aged 30, 1st child, Quintile 4, Frequent attender) | The only reason I registered was because I knew that I had to stop and by going and registering it would give me an actual date – this is the date and I would say right… Since I’ve been part of the scheme, it has given me that incentive to stop and given me the date, because I was going every week to do the breathalyser thing. (…) I did pretty much do it on my own, but it was worth it to go every week and speaking to the chemist. It gave me that bit of encouragement, ‘Oh you are doing well.’ (…) It was quite good to see the numbers (CO test results) - it was that as well. |
C1 (Area 2, Aged 22, 1st child, Quintile 1, Frequent attender) | Interviewer: Has having the money made a difference to you in any way? |
Respondent: It is hard to tell but if the scheme was done without the £12.50 then I probably wouldn’t make as much effort to go to the chemist and speak to Tracy and all this kind of stuff (…) So yeah the £12.50 and being on the scheme does help, it’s been a bit more of a push. It is a bit easier than just trying on your own - It is good to go down and have your test done and be all proud of yourself and say I’m on the GIUFB scheme - But if I wasn’t on the scheme and I wasn’t getting £12.50 I would still be doing it anyway and I’d still be trying my hardest. | |
C18 (Area 1, Aged 36, 1st child, Quintile 1, Infrequent attender) | For me getting my breath checked – It felt like, if I was to get my carbon monoxide – carbon dioxide measurements – that’s going to give me my incentive – knowing that (I was clear). The money was just a bonus; do you know what I mean? |
Sources | Quotes |
---|---|
C13 (Area 2, Aged 38, 4th child, Quintile 1, Frequent attender) | I’d never thought about giving up smoking. But I mean I didn’t smoke a lot anyway. I wasn’t a heavy smoker. But I just thought with being pregnant I wanted to try and quit it altogether…. It was just a matter of going in, once a week and getting the breath test and seeing how my nicotine level was, and they gave me the patches… But because I wasn’t a heavy smoker, I just kept a hold of the patches and everything; everything just seemed to go, really, really well. |
C13 (Area 2, Aged 38, 4th child, Quintile 1, Frequent attender) | Interviewer: What would you have done if the money hadn’t been available? |
Respondent: I would have gave it up for her. I just think because the money was there it was – it was a way of making me stronger… | |
Interviewer: You’d not even had a wee lapse? | |
Respondent: Nah! Nothing! Nothing! No once I’d given up, I’d given up and that was it. I only needed the patches for quite a short period of time… There was sometimes when I forgot to put it on, you know? And I didn’t even notice. The money wasn’t like a giant (incentive)…but that was why we took it, we took it because, yeah it’ll help get everything for her, that was the reason we took the incentive because of the money for her. | |
C17 (Area 1, Aged 22, 1st child, Quintile 1, Frequent attender) | I stopped, because I knew I was pregnant, I was wanting to do everything sort of right. And then I heard about this and that made us more determined as well like. (…) I was determined to stop smoking at the time and that’s what it was, just one day I just said right we ain’t smoking, and we never smoked. |
Sources | Quotes |
---|---|
C2 (Area 2, Aged 26, 5th child, Quintile 1, Infrequent attender) | There has been a few attempts, a lot of attempts and the first few times it was only like a week or so I managed… but I did want to give up, I wanted to give up when I was pregnant with her but I just, I don’t know, I just couldn’t (…) Sometimes the doctors kind of, they kind of look down their nose at you and it’s like “Oh you’ve been here before, you never managed you know, the past three, four times, what makes you so sure you’re going to manage now?”, and they don’t have much compassion I suppose the word is. |
C2 (Area 2, Aged 26, 5th child, Quintile 1, Infrequent attender) | I was at the chemist seeing if I could get patches without having to go to the doctor and she took me in to this little room and gave me loads of leaflets and one of them was about this baby thing, I wasn’t really too bothered about it but she put my name down and everything anyway because I wasn’t sure at the time whether I’d be able to stick to it or not so, but that’s how I heard about it. (…) She asked me if I wanted to go for it or not and I kind of felt obliged to because I was just in this wee room and there wasn’t much going on, there was all these leaflets in front of me and I just kind of, I mean I only went in there to get patches and I was getting hit with all this stuff and I was like ‘Just put my name down, whatever’. |