How Much Money Can I Save If I Quit Smoking

DAVID WAHLBERG

Offering gift cards to pregnant women on Medicaid who smoke if they receive home visits and calls encouraging them to quit could save money by reducing health care costs from conditions such as preterm birth and asthma, according to a UW-Madison study.

The study involved more than 1,000 pregnant women on Wisconsin's Medicaid program in 2012 to 2015 who smoked or recently quit and were at risk of starting again. Half were paid up to $460 to get home visits and tobacco counseling calls through a program called First Breath. The other women got up to $80 to participate in related testing.

Six months after their babies were born, 14.7% of those who got the financial incentives for counseling weren't smoking, compared to 9.2% of the other group.

A cost-benefit analysis showed it would cost $3,399 to help an additional baby grow up smoke-free, an investment that would pay for itself by decreasing associated medical costs. For example, the researchers said asthma risk is 85% greater for young children if their mothers smoke, and asthma treatment costs $3,279 a year for children on Medicaid. Other related conditions include sudden infant death, wheezing and cognitive defects.

"If (Medicaid) can be successful at reducing smoking rates, they could be essentially saving themselves money that they're putting into something like these incentives," said Marlon Mundt, a UW-Madison health economist and lead author of the study, published recently in the journal Preventive Medicine.

Most pregnant women on Medicaid who smoke want to quit but face many barriers, including high stress levels and often living with other smokers, said Kristine Alaniz of the Wisconsin Women's Health Foundation, which runs the First Breath program.

"The odds are really stacked against them," Alaniz said. "The quitting process is fraught with emotional and physical challenges, so those financial incentives provide a clear, tangible reward system that helps people stay focused."

Sunni Gennis, of Weyauwega, participated in the study before and after the birth of her son, who is 7 years old. She has another son who is 4. She quit smoking for only about two weeks but said the program helped her cut her cigarette use by half today and find therapy to end an addiction to prescription opioids.

"The home visits were extremely beneficial to me," Gennis said. "I don't know that I would have given it my time if (money) wasn't offered."

The Wisconsin Women's Health Foundation began incorporating smaller financial incentives into the First Breath program following the study and hopes Medicaid adds them, Alaniz said.

The state Department of Health Services has no plans to adopt such incentives, spokesperson Jennifer Miller said. "The study results provide an interesting perspective on how to further address tobacco cessation for individuals who are pregnant," she said.

About 7% of U.S women report smoking during pregnancy, and 85% of women who quit smoking while pregnant relapse in the six months after delivery, the researchers said. Smoking rates are considerably higher among pregnant women on Medicaid, Alaniz said.

In the study, those in the incentive group got $20 to $40 gift cards for each home visit, counseling call or test for tobacco abstinence. The average total received was $220.

About 16% of women in the study got a tobacco cessation medication from their doctor to help them quit, one of the related expenses built into the cost-benefit analysis, Mundt said.

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