Content area
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.
Details
; Breunis, Leonieke J 2
; Tessa Scheffers-van Schayck 3 ; Bauld, Linda 4 ; Ista, Erwin 5 ; Been, Jasper V 6 1 Division of Neonatology, Department of Neonatal and Paediatric Intensive Care, Erasmus MC Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands; Department of Epidemiology, Trimbos Institute, Utrecht, Netherlands
2 Department of Obstetrics and Gynaecology, Erasmus MC Sophia Children’s Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands; Department of Paediatrics, Erasmus MC Sophia Children’s Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands
3 Department of Youth, Trimbos Institute, Utrecht, Netherlands
4 Usher Institute and Behavioural Research UK, The University of Edinburgh, Edinburgh, UK
5 Division of Paediatric Intensive Care, Department of Neonatal and Paediatric Intensive Care, Erasmus MC Sophia Children’s Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands; Section Nursing Science, Department of Internal Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
6 Division of Neonatology, Department of Neonatal and Paediatric Intensive Care, Erasmus MC Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands; Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands