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Citation

Ussher M, Best C, Lewis S, Bauld L, McKell J, Orton S, Cooper S & Coleman T (2026) Financial incentives for maintaining postpartum smoking abstinence: 3-4-year follow-up of the Financial Incentives for Prevention of Postpartum Return to Smoking (FIPPS) randomised controlled trial. Addiction. https://doi.org/10.1111/add.70505

Abstract
Background and aims We followed up a financial incentives trial aimed at maintaining smoking cessation postpartum, which showed some positive effects at one year, to assess sustained abstinence at 3–4?years postpartum. Design, setting and participants Secondary analysis of longer-term outcomes of a pragmatic, multi-centre, three-arm randomized controlled trial, recruiting 462 postpartum women in England, aged ≥16?years, having stopped smoking during pregnancy with financial incentives, validated as abstinent at end of pregnancy or early postpartum. Interventions: (1) usual care (UC); (2) UC plus up to ?60 of voucher incentives offered to participants and ?60 offered to significant-other supporters, over 3 months postpartum, contingent upon validated abstinence (‘3-months incentives’); or (3) UC plus ‘3-months incentives’ plus ?180 of vouchers offered to participants over 9 months postpartum (leading to a maximum of ?240 of incentives for participants, plus ?60 for significant others), contingent upon validated abstinence (‘12-months incentives’). Participants who did not achieve sustained abstinence at one year were included as non-abstainers but were not followed-up. Measurements Primary outcome: biochemically validated abstinence at 3–4 years postpartum. Statistical significance was set at P?

Keywords
financial incentives; intervention; maintenance; postpartum; pregnancy; randomized controlled trial; relapse prevention; smoking; smoking abstinence; vouchers

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