Preliminary Effectiveness of Enhanced Text Message + Incentives

This study is a preliminary evaluation of a smoking cessation intervention designed for pregnant women that combines text message support and financial incentives. The aims of this study are to determine the preliminary feasibility and acceptability of text message + incentives (intervention) vs. text message only (control).

Pregnant women who smoke and their babies are exposed to known carcinogens and smoking is associated with adverse maternal and birth outcomes. Low-income pregnant women are particularly at risk because they have higher smoking rates and are less likely to quit. Despite continued smoking, most pregnant smokers do not receive smoking cessation counseling and only one in 10 receive referrals to cessation services or follow-up care. Incentives for smoking cessation yield the highest effect sizes of any intervention for pregnant women. Most prior studies evaluating incentives for smoking cessation in this population have used time and resource-intensive in-person visits to verify abstinence for contingent reinforcement. The long-term goal of this research is to reduce the burden of tobacco use by developing and evaluating a highly scalable, effective intervention to support smoking cessation during pregnancy.

Inclusion Criteria: * Pregnant women aged: 18+ * Enrolled in the Special Supplemental Nutrition Program for women, Infants, and Children (WIC) or Medicaid (or applied/applying) * Self-reported current daily smokers * Able to communicate in English * Access to a mobile phone capable of receiving text messages Exclusion Criteria: * Not at all interested in quitting * Smoke less than 24 days in the past month * Greater than 30 weeks gestation