Recent research done by Glasgow and Stirling University has revealed that pregnant women are more likely to stop smoking when incentivised by shopping vouchers. Their research found that 23% of pregnant women stopped smoking when promised £400 of vouchers, whereas only 9% stopped of their own accord without an incentive.
From a cynical or even a practical point of view it might be worth £400 for the NHS to do everything it can to support the birth of healthy children, but this still leaves 68% of women continuing to smoke when pregnant, even after a financial incentive has been offered to them.
Why is it that sometimes we need extra help to do the right thing? These days we are constantly bombarded with information about the right way to live, what we need to do to support good health, what we should be eating, drinking, the best exercise regimens, what's deemed to be appropriate alcohol consumption; you'd think that by now we'd be programmed to do the right thing in every area of our lives!
How is it then that some of us still struggle to do the right thing and find it hard, for example, to stop smoking when pregnant? It's often the case that smoking, and indeed many other habit and behaviour patterns, are often part of the more complicated relationship we have with rewards, treats and managing our lives.
Could it be that some people lead stressful lives and regard their cigarettes, booze or chocolate, their shopping or betting on the horses as a quick fix, the one friend they can rely on in times of stress or upset, the thing that guarantees immediate relief, helps them feel better for a while. Taking a few minutes for a cigarette break or having something that provides respite can be a very seductive option, even if it brings regrets afterwards at having given in to the temptation.
In the case of pregnancy, a woman may have had a long-established relationship with cigarettes which she struggles to sever; she may have anxieties at being pregnant and is relying on cigarettes to help her get through. Other women may choose to continue smoking when pregnant because they've heard that it makes the baby smaller and therefore the birth easier. Some women may feel that cigarettes keep them calm and that they're better off with them than without them.
Surely though there's some concern at offering cash inducements and bribes for people to forgo their bad habits in order to take responsibility for their health and well-being. What about the people who are already committed to 'doing the right thing' and consequently lose out on receiving these benefits?
Might it be more appropriate to offer those others actual support in order for them to become more confident, improve their self-esteem, find ways to become more assertive, manage stress better, learn ways to overcome past experiences if relevant? Therapy, education and training can help in adopting better habits.
Is there a danger of handouts becoming viewed as a quick fix to all problems? I'm aware of a local school which offers a points system for troublesome children. Every time they're 'good' they're awarded points which are posted on a big wall chart for all to see. At the end of the year the 'best' of the troublesome children stand the chance of winning a bicycle. The other 'good', well-behaved children are excluded from this opportunity, presumably on the basis that being good brings its own reward!
Other schemes are in place that pay people to lose weight. From an accountancy perspective these schemes may have some merit. A few thousand pounds in rewards may save the hard-pressed NHS a fortune from the potential health implications of obesity, but are we really wanting to cultivate a nation of people who look to others for a handout before they choose to take responsibility for their own health and well-being, or for the well-being of their unborn children?
How about rewarding the good guys, the men and women who look after their bodies, take good care of themselves, follow a healthy diet, exercise regularly and aim to take responsibility for themselves? How about encouraging and supporting, rather than paying off or demonising those who find it hard to break away from old habits. Let's provide appropriate education, encouragement and support which enables people to feel motivated rather than lectured at or berated. Doing the right thing sometimes requires a little extra help. Let's look to provide that help appropriately.