{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T19:12:57Z","timestamp":1790795577509,"version":"4.1.0"},"reference-count":57,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,6,14]],"date-time":"2022-06-14T00:00:00Z","timestamp":1655164800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To measure the cost\u2010effectiveness of adding text message (TMB), exercise (EB) and abstinent\u2010contingent financial incentive\u2010based (CFIB) stop smoking interventions to standard smoking cessation support for pregnant women in England.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Modelling cost\u2010effectiveness outcomes by separately adding three cessation interventions to standard cessation care offered to pregnant women in England. English National Health Service Stop Smoking Services (NHS SSS) statistics from 2019 to 2020 were used for estimating the base quit rate. Intervention effectiveness and cost data for interventions were taken from trial reports. Cost\u2010effectiveness was derived using the economics of smoking in pregnancy (ESIP) model from a health service and personal social services perspective. Interventions were compared with each other as well as against standard cessation care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>English NHS SSS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants\/cases<\/jats:title><jats:p>A total of 13\u2009799 pregnant women who accessed NHS SSS. Interventions and comparator; comparator: standard stop smoking support comprising behavioural intervention and an offer of nicotine replacement therapy (NRT). Three additive interventions were TMB, EB and CFIB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Incremental cost\u2010effectiveness ratios per quality\u2010adjusted life\u2010years gained for both mothers and offspring over their life\u2010times; return on investment (ROI); and cost\u2010effectiveness acceptability curves (CEACs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>The addition of any of the interventions compared with standard care alone was preferred, but only significant for the addition of CFIB, with the CEAC suggesting an at least 90% chance of being favoured to standard care alone. When compared against each other CFIB appeared to yield the largest returns, but this was not significant. The estimated ROI for CFIB was \u00a32 [95% confidence interval (CI)\u2009=\u2009\u00a31\u20133] in health\u2010care savings for every \u00a31 spent by the NHS on the cessation intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For a health system which currently provides behavioural support and an offer of nicotine replacement therapy as standard stop smoking support for pregnant women, the greatest economic gains would be provided by operating an abstinent\u2010contingent financial incentives scheme alongside this.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.15968","type":"journal-article","created":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T07:14:38Z","timestamp":1654499678000},"page":"2907-2917","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Investigating the cost\u2010effectiveness of three cessation interventions on a national scale using the Economics of Smoking in Pregnancy (ESIP) decision analytical model"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4824-9724","authenticated-orcid":false,"given":"Matthew","family":"Jones","sequence":"first","affiliation":[{"name":"NIHR School for Primary Care Research University of Nottingham Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murray","family":"Smith","sequence":"additional","affiliation":[{"name":"Community and Health Research Unit University of Lincoln Lincolnshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Lewis","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Public Health University of Nottingham Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Parrott","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of York York UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7303-4805","authenticated-orcid":false,"given":"Tim","family":"Coleman","sequence":"additional","affiliation":[{"name":"NIHR School for Primary Care Research University of Nottingham Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-7-65"},{"key":"e_1_2_8_3_1","volume-title":"Infant Feeding Survey 2010: early results","author":"NHS Information Centre, Infant Feeding Survey (IF) Research","year":"2011"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/003335491312800308"},{"key":"e_1_2_8_5_1","volume-title":"Australia's Mothers and Babies 2012","author":"Hilder L","year":"2014"},{"key":"e_1_2_8_6_1","first-page":"385","article-title":"Effect of maternal cigarette smoking on pregnancy complications and sudden infant death syndrome","volume":"40","author":"DiFranza JR","year":"1995","journal-title":"J Fam Pract"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(98)00089-0"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.309.6959.901"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(00)70240-7"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2007.07.015"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/003335491513000310"},{"key":"e_1_2_8_12_1","volume-title":"Estimating the Costs to the NHS of Smoking in Pregnancy for Pregnant Women and Infants","author":"Godfrey C","year":"2010"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.14183"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8510(99)00039-1"},{"key":"e_1_2_8_15_1","volume-title":"Economic Analysis in Health Care","author":"Morris S","year":"2007"},{"key":"e_1_2_8_16_1","first-page":"164","article-title":"Economic evaluation enhances public health decision making. 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