Partnership funding with Cancer Research UK for the Cessation in Pregnancy Incentives Trial (CPIT): A multi-centre phase III Randomised Controlled trial.

Partnership funding with Cancer Research UK for the Cessation in Pregnancy Incentives Trial (CPIT): A multi-centre phase III Randomised Controlled trial. The numbers of women who smoke during pregnancy in the UK has been in decline over recent decades but there is great variation in smoking in pregnancy rates in different populations. Finding effective approaches to tackle smoking in pregnancy therefore remains highly relevant. The Cessation in Pregnancy Incentives Trial (CPIT III) is a multi-centre trial, based in the UK and led by the University of Glasgow, which aims to provide definitive evidence to support the effectiveness and cost effectiveness of using financial incentives to promote and support smoking cessation in pregnant women. By offering shopping vouchers alongside routine support from NHS stop smoking services, the trial is investigating the impact on smoking rates at the end of pregnancy and 6 months post-partum. CPIT III is based on an earlier feasibility trial (CPIT II) which took place in the NHS Greater Glasgow and Clyde health board area, completed in 2013, which found that financial incentives were effective in increasing smoking cessation rates in women in the intervention group compared to those in the control group. CPIT III is funded by: Cancer Research UK; the Chief Scientist Office of the Scottish Government; Health and Social Care Services Northern Ireland, Chest Heart & Stroke Northern Ireland; the Lullaby Trust; and the Scottish Cot Death Trust.

Partnership funding was provided by the Chief Scientist Office of the Scottish Government to a research team at the University of Stirling to carry out a mixed method process evaluation of the trial based on a case study approach. The process evaluation will seek to identify from case studies of 5 of the 7 sites involved in CPIT III, possible barriers and facilitators to the implementation of financial incentives within different contexts, involving different service characteristics, geographies and populations. Findings from the process evaluation will provide important evidence valuable for any possible, future rollout of financial incentives to support smoking cessation in pregnancy in the UK. Evidence is required by the National Institute for Health and Care Excellence (NICE) to enable a recommendation for NHS smoking cessation services to use financial incentives to support smoking cessation in pregnant women.

Conducting the case studies involved observation of usual care of pregnant smokers in maternity and smoking cessation services; as well as in-depth interviewing of a sample of study participants (intervention and control) and maternity and smoking cessation service staff members in each trial site. Additional observations were recorded in relation to trial meetings and the reflections of trial staff members.

The trial protocol was published in Trials in 2020. The research team expect to submit their final report (including findings from the process evaluation) to funders by the end of November 2021.