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Should pregnant women be paid to quit smoking?

The health effects of smoking while pregnant are well documented, yet many expectant mothers continue to light up. What can be done to help pregnant women kick the habit? In Scotland, they wanted to find out.

They decided to pay 612 women to quit, according to a study published in The BMJ. All of the women had reported they were less than 24 weeks along and were at least 16 years old. They were split into two groups. One went through a smoking cessation program and received free nicotine replacement therapy for 10 weeks along with four weekly phone calls for support (the control group). The other group got the same treatment along with shopping vouchers worth about $600.

The money was doled out at different times: when the women went to a counseling session and set a quit date, if they stopped for two weeks, if they were still smoke-free at 12 weeks and if they managed not to smoke through the end of their pregnancies.

Of the women, 23 percent of them in the paid group quit smoking, while just 9 percent who were not paid stopped smoking. A year later, 15 percent of the paid women were not smoking, as was 4 percent of the non-paid women.

According to the researchers, smoking during pregnancy costs the UK anywhere from $8 million to $97 million a year for extra health care costs, and $18 million to $35 million for the babies during their first year of life.

But, is paying women the answer to prevent them from smoking while pregnant?

Dr. David Tappin, a professor of clinical trials at the University of Glasgow, who headed up the study, said that could give pregnant smokers a reward for being what some people believe is reckless.

“Every mother knows that to be pregnant is a challenge as well as a joy,” Tappin told NPR. “For a lot of these women, it’s just a challenge. A lot of them have poor housing, difficult relationships, poor self-esteem. The prospect of a new baby can be overwhelming.”

Recently, a county program in Ohio announced that pregnant smokers could receive vouchers for diapers if they kick the habit. It’s based off a similar program launched over a decade ago in New York.

Now, I am all about having healthy children. And I know the reality: Many women won’t stop smoking even when they know they are pregnant. As a former smoker, I often grew anxious when worrying about having to quit if I ever became pregnant.

But, is taking taxpayer’s money and shoving it at the problem really the solution? I don’t think so. I think we can do better.

The aforementioned program, while somewhat successful, didn’t have glowing results. Perhaps, if all the women stopped smoking, it might be worth looking into. But, 23 percent? What about all the money lost in the program?

They got some women to stop smoking while pregnant. What about after the children were born? Many mothers went back to smoking. And those kids are still living with effects from it — it’s called second-hand smoke, and it would be interesting to know how much money that costs the health care system.

Nothing is for free. These programs come at a cost. And while the idea is nice, it’s not exactly financially feasible, I suspect.

But, I also see the uneducated mentality continue to perpetuate throughout our society, and I wonder why. Why aren’t women being educated about the harmful effects of smoking? If they know it’s harmful, why are they still smoking when they get pregnant?

If we start to answer that question, I think we can trace back and try to solve the issue before it begins — before we just throw taxpayer money at it and hope that works. Perhaps that will still involve money, but an earlier intervention could save us more money in the long term. Most importantly, it may be able to protect children from being victims before they even come into our world.

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