Financial incentives for smoking cessation among (expectant) parents: a systematic review of facilitators and barriers to implementation

Linda van der Spek; Leonieke J Breunis; Tessa Scheffers-van Schayck; Linda Bauld; Erwin Ista; Jasper V Been

doi:10.1136/tc-2024-059198

Financial incentives for smoking cessation among (expectant) parents: a systematic review of facilitators and barriers to implementation

Linda van der Spek^*
, Leonieke J Breunis
, Tessa Scheffers-van Schayck
, Linda Bauld
, Erwin Ista
, Jasper V Been

^*Corresponding author for this work

Trimbos Institute, Netherlands Institute of Mental Health and Addiction
University of Edinburgh

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

OBJECTIVE:

Financial incentives, provided following validated smoking cessation, hold substantial potential to cost-effectively promote cessation. To facilitate wider adoption, we systematically reviewed evidence addressing the barriers and facilitators to successful implementation of incentive-based smoking cessation interventions among (expectant) parents.

DATA SOURCES:

We conducted a systematic search to identify scientific and grey literature across nine electronic databases, from inception to 15 August 2024. Search terms included combinations of "smoking cessation", "incentive", "pregnancy", "preconception" and "parent".

STUDY SELECTION:

Eligible records reported and reflected on the implementation of smoking cessation programmes with incentives for (expectant) parents. Inclusion criteria were applied by two reviewers independently, with discrepancies resolved through consensus. Of 1100 unique records identified, 37 met inclusion criteria.

DATA EXTRACTION:

Characteristics of the studies, interventions, incentives and implementation, along with barriers and facilitators, were independently extracted by two reviewers. Thematic analysis identified barriers and facilitators. Subgroup analysis explored patterns specific to lower socioeconomic populations.

DATA SYNTHESIS:

Studies reported on implementation in the USA (n=18), UK (n=10), Australia (n=4), the Netherlands (n=2), New Zealand (n=1), France (n=1) and international contexts (n=1). Barriers included misalignment with participants' context and resources, recruitment and retention challenges, limited reliability of abstinence verification and high resource demands. Facilitators included ensuring acceptability, accessibility, feasibility, funding and integration into health services.

CONCLUSIONS:

With the cost-effectiveness of financial incentives for smoking cessation among (expectant) parents already well-documented, this first systematic synthesis of the barriers and facilitators to implementing them in daily practice offers valuable guidance for advancing implementation efforts.

PROSPERO REGISTRATION NUMBER:

2023:CRD42023407648.

Original language	English
Article number	e059198
Journal	Tobacco Control
Early online date	22 Apr 2025
DOIs	https://doi.org/10.1136/tc-2024-059198
Publication status	E-pub ahead of print - 22 Apr 2025

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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Financial incentives for smoking cessation among (expectant) parentsFinal published version, 489 KBLicence: CC BY-NC

Cite this

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title = "Financial incentives for smoking cessation among (expectant) parents: a systematic review of facilitators and barriers to implementation",

abstract = "OBJECTIVE: Financial incentives, provided following validated smoking cessation, hold substantial potential to cost-effectively promote cessation. To facilitate wider adoption, we systematically reviewed evidence addressing the barriers and facilitators to successful implementation of incentive-based smoking cessation interventions among (expectant) parents.DATA SOURCES: We conducted a systematic search to identify scientific and grey literature across nine electronic databases, from inception to 15 August 2024. Search terms included combinations of {"}smoking cessation{"}, {"}incentive{"}, {"}pregnancy{"}, {"}preconception{"} and {"}parent{"}.STUDY SELECTION: Eligible records reported and reflected on the implementation of smoking cessation programmes with incentives for (expectant) parents. Inclusion criteria were applied by two reviewers independently, with discrepancies resolved through consensus. Of 1100 unique records identified, 37 met inclusion criteria.DATA EXTRACTION: Characteristics of the studies, interventions, incentives and implementation, along with barriers and facilitators, were independently extracted by two reviewers. Thematic analysis identified barriers and facilitators. Subgroup analysis explored patterns specific to lower socioeconomic populations.DATA SYNTHESIS: Studies reported on implementation in the USA (n=18), UK (n=10), Australia (n=4), the Netherlands (n=2), New Zealand (n=1), France (n=1) and international contexts (n=1). Barriers included misalignment with participants' context and resources, recruitment and retention challenges, limited reliability of abstinence verification and high resource demands. Facilitators included ensuring acceptability, accessibility, feasibility, funding and integration into health services.CONCLUSIONS: With the cost-effectiveness of financial incentives for smoking cessation among (expectant) parents already well-documented, this first systematic synthesis of the barriers and facilitators to implementing them in daily practice offers valuable guidance for advancing implementation efforts.PROSPERO REGISTRATION NUMBER: 2023:CRD42023407648.",

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note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.",

year = "2025",

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doi = "10.1136/tc-2024-059198",

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AU - van der Spek, Linda

AU - Breunis, Leonieke J

AU - Scheffers-van Schayck, Tessa

AU - Bauld, Linda

AU - Ista, Erwin

AU - Been, Jasper V

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N2 - OBJECTIVE: Financial incentives, provided following validated smoking cessation, hold substantial potential to cost-effectively promote cessation. To facilitate wider adoption, we systematically reviewed evidence addressing the barriers and facilitators to successful implementation of incentive-based smoking cessation interventions among (expectant) parents.DATA SOURCES: We conducted a systematic search to identify scientific and grey literature across nine electronic databases, from inception to 15 August 2024. Search terms included combinations of "smoking cessation", "incentive", "pregnancy", "preconception" and "parent".STUDY SELECTION: Eligible records reported and reflected on the implementation of smoking cessation programmes with incentives for (expectant) parents. Inclusion criteria were applied by two reviewers independently, with discrepancies resolved through consensus. Of 1100 unique records identified, 37 met inclusion criteria.DATA EXTRACTION: Characteristics of the studies, interventions, incentives and implementation, along with barriers and facilitators, were independently extracted by two reviewers. Thematic analysis identified barriers and facilitators. Subgroup analysis explored patterns specific to lower socioeconomic populations.DATA SYNTHESIS: Studies reported on implementation in the USA (n=18), UK (n=10), Australia (n=4), the Netherlands (n=2), New Zealand (n=1), France (n=1) and international contexts (n=1). Barriers included misalignment with participants' context and resources, recruitment and retention challenges, limited reliability of abstinence verification and high resource demands. Facilitators included ensuring acceptability, accessibility, feasibility, funding and integration into health services.CONCLUSIONS: With the cost-effectiveness of financial incentives for smoking cessation among (expectant) parents already well-documented, this first systematic synthesis of the barriers and facilitators to implementing them in daily practice offers valuable guidance for advancing implementation efforts.PROSPERO REGISTRATION NUMBER: 2023:CRD42023407648.

AB - OBJECTIVE: Financial incentives, provided following validated smoking cessation, hold substantial potential to cost-effectively promote cessation. To facilitate wider adoption, we systematically reviewed evidence addressing the barriers and facilitators to successful implementation of incentive-based smoking cessation interventions among (expectant) parents.DATA SOURCES: We conducted a systematic search to identify scientific and grey literature across nine electronic databases, from inception to 15 August 2024. Search terms included combinations of "smoking cessation", "incentive", "pregnancy", "preconception" and "parent".STUDY SELECTION: Eligible records reported and reflected on the implementation of smoking cessation programmes with incentives for (expectant) parents. Inclusion criteria were applied by two reviewers independently, with discrepancies resolved through consensus. Of 1100 unique records identified, 37 met inclusion criteria.DATA EXTRACTION: Characteristics of the studies, interventions, incentives and implementation, along with barriers and facilitators, were independently extracted by two reviewers. Thematic analysis identified barriers and facilitators. Subgroup analysis explored patterns specific to lower socioeconomic populations.DATA SYNTHESIS: Studies reported on implementation in the USA (n=18), UK (n=10), Australia (n=4), the Netherlands (n=2), New Zealand (n=1), France (n=1) and international contexts (n=1). Barriers included misalignment with participants' context and resources, recruitment and retention challenges, limited reliability of abstinence verification and high resource demands. Facilitators included ensuring acceptability, accessibility, feasibility, funding and integration into health services.CONCLUSIONS: With the cost-effectiveness of financial incentives for smoking cessation among (expectant) parents already well-documented, this first systematic synthesis of the barriers and facilitators to implementing them in daily practice offers valuable guidance for advancing implementation efforts.PROSPERO REGISTRATION NUMBER: 2023:CRD42023407648.

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DO - 10.1136/tc-2024-059198

M3 - Article

C2 - 40262855

SN - 0964-4563

JO - Tobacco Control

JF - Tobacco Control

M1 - e059198

ER -

Financial incentives for smoking cessation among (expectant) parents: a systematic review of facilitators and barriers to implementation

Abstract

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UN SDGs

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