Written by Marianne MansfieldI want a sports car. I’d call it a midlife crisis thing, but in my case that would be stretching the definition of midlife beyond credulity. Nonetheless I want one, whatever the motivation. My husband, in a moment of mental near-collapse, told me that I should pursue my sports car dream because I “wasn’t getting any younger.” His stitches will be removed next week.
I zeroed in on a specific make, model, and color and commenced searching the Internet. After some hunting, I located a car meeting my specs at a dealership in Arizona. We called and began what initially appeared to be a promising negotiation over the phone. We were nearly to the point of making a plan to drive down and pick up what had by then become my car, if only in my mind, when our dealer contact said, “In the spirit of full disclosure, I need to disclose that the car does smell slightly of cigarette smoke.”
And the deal died. Done. Over that quickly. The deal was totally and completely squelched. I am a former smoker and the very last thing I want is a car that smells like I still maintain that disgusting habit; which explains in part why I was drawn in by an NPR story detailing the results of what happened when Scottish pregnant women were paid to quit smoking during their pregnancies.
To summarize, researchers at Glasgow University paid 609 women up to 400 pounds or $607 dollars if they quit smoking and stayed off cigarettes for up to one year from their quit date. After 12 months approximately 15 percent of the women were smoke free, as opposed to only 4 percent of the control group.
The benefits are obvious. Women who smoke during pregnancy are at increased risk of miscarriage, preterm delivery, lower birth weight and sudden infant death syndrome, according to the Center for Disease Control and Prevention.
What this study shows is that not only are the lives of these women and their babies at stake, but also there exists a financial incentive to keeping both groups healthy. The Scottish researchers estimate that smoking during pregnancy costs the United Kingdom $8 million to $97 million a year in extra health care costs for women, and $18 million to $35 million in the first year of the baby’s life.
So what is the downside you might ask?
There are those who argue that incentivizing behavioral changes is akin to openly paying people to stop being reckless with their well-being. Despite the fact that financial incentives seem to work not only in the case of pregnant smokers but have also had some success in people who are obese, the process gnaws at the sensibilities of some. It grates to pay people to take responsibility for their own decisions. People who are overweight should control their calorie intake and exercise more.
Women who are thinking of getting pregnant, or who become so without having intended to, should be expected to do what is best for their health and that of their unborn babies. In both instances, it is a simple exercise in common sense. Take care of yourself and you will likely live longer. It is simply the right thing to do. So just do it already.
Not so easy.
Although I’ve never been a pregnant woman, I have been a smoker and I know how wretchedly difficult it is to quit. If simply wanting to quit, or in the case of the obese wanting to lose weight, were all that was required, financial incentives would likely not be on the table.
Quitting smoking is the hardest change in my behavior I have ever made. I wish I had a dollar for every pack of cigarettes I crushed and threw away, vowing I would never put another to my lips, only to crumple hours later to that relentless craving. It was a nagging that started in my stomach and slithered its way up to my brain so that soon all I could focus on was how quickly I could inhale my next puff. I tried the gum, I tried the patches. I even tried hypnosis. Nothing worked until I found the guts to tough it out. I steeled myself to endure the craving, to re-pattern the habitual behavior, and to relearn how to enjoy the companionship of my friends who still smoked. After more than one back slide, my backbone ultimately won out.
So, I get why quitting smoking is so damned hard. I can only imagine how difficult it must be to contemplate quitting when a woman is the midst of all the changes, physical, psychological and hormonal, during pregnancy.
Is it bribery to offer a gift card? Probably. Is it immoral? Unethical? I think not. In this case the end definitely does justify the means. The potential upside is worth it. Healthy babies, healthy family members, and less economic costs.
Is there really a downside?
Not in my mind.
Marianne Mansfield has lived in Southern Utah since 2010. She and her husband followed their grandchildren to this area from Michigan. In her former life she was a public school educator. More than half of her career was spent as an elementary principal, which is why her response to most challenges is, “This isn’t my first rodeo.” She grew up in Indiana, and attended Miami of Ohio, Ball State University and Michigan State. She is a loyal MSU Spartan and Detroit Tiger baseball fan. She has been writing fiction and opinion since her retirement in 2004.
