What about the Wealthy Pregnant-smokers?

My initial reaction to the news that cash incentives are being considered for sucessfully quitting smoking whilst pregnant, was total shock. I was completely astounded that anyone would suggest it, even more so that enough people would go along with it, or give it the time of day, for it to become a talking point.

After reading more and chatting about it, I’ve simmered down a little, as is usually the case because my reactions do tend to be a little ‘knee-jerk’ at times. Having read, talked and thought more about it though, I can see some of the reasons that a scheme like this is being considered.

But realistically, can we really go there? Can we really be comfortable with rewarding parents for finding more motivation in the promise of £400 than in the increased likelihood of having a healthy baby?

Let me explain my thinking here because I really do not mean to over-simplify things or throw around accusations…

To be clear about my position, I am a non-smoker and I have never carried a child. I’ve been around children all of my life, I have 5 brothers and sisters, a niece and two nephews and I consider myself to be pretty maternal. I don’t particularly like it when I see a pregnant woman smoking, as I’m sure most people will agree with what we now know about cigarettes, it’s never a very nice thing to see.

That said, I am not passing judgement on mothers who cannot quit smoking when pregnant. As I’ve said, I’m not a smoker and have never been pregnant, I’m not in a position to understand the reasons why some people cannot quit. I have both friends and family who haven’t been able to stop smoking while they were pregnant, as well as both family and friends who have.

I can also say with confidence that some of the best and most devoted mothers that I have the privilege to know and to learn from, have been unable to stop smoking while pregnant. Some were ill-informed about the dangers (and yes that is still the case even today, in some cases), some didn’t believe it was as dangerous as they were told, and some just simply could not stop.

It isn’t called an addiction for nothing.

To be addicted to something is to be both ‘physically and mentally dependent‘ on it. So as much as I hate it and would love everyone that I care about to stop doing it forever, tomorrow, it’s clear that smoking can become a significant physical and psychological element of people’s lives. Therefore surely it follows that as pregnancy is a time of massive change and anxiety in the best of cases, quitting smoking at that time may not be quite as easy as it sounds.

What I can’t find any wiggle room with though, no matter how much I try and what angle I look at it from, is this…

Surely if you can stop smoking for £400 worth of shopping vouchers, then you were always capable of quitting for the health of your child.

I am all for providing as much support as possible for women to quit when, and if possible even before, they are pregnant (the same goes for their partners, who are just as responsible and whose fumes can also harm the baby). Anything that can help increase the amount of babies born 100% healthy is always worth spending money on, as far as I’m concerned.

But to me this just seems like a way of continuing to encourage the attitude that is so rampant across a lot of our country (we are actually, on the whole, a pretty privileged society after all, whether we care to admit it or not) that everything, perhaps even the wellbeing of our children, is someone else’s responsibility. “If they give me money to stop, then I’ll be able to stop, but if I’m being left to do it alone, how am I supposed to manage?” That sort of thing.

The idea is to offer vouchers in stages, totalling £400 throughout the pregnancy, as a reward for succesfully engaging with smoking cessation services which already exist. That’s right, services that already exist and that you can access for free. So if you want that type of support (and think that it may work for you) it’s there. If you think that type of service will help you, then join it. If you do engage in these services but find you are unable to successfully quit (i.e. you’re supposedly one of the women targeted by this scheme), that is not something that I at least, would ever judge you for. But what I don’t understand is how on earth the addition of shopping vouchers could make a difference?

Put simply, if you are so addicted (which I fully believe you can be) that you cannot quit for your baby, how can you do it for money?

And thinking more generally, how could waves of people engaging in these services for no reason other than to take home their voucher, achieve lasting results?

Anyway, I don’t buy the idea that money is a motivator and certainly not one strong enough to convince a body and a mind that they no longer need nicotine. If I’m wrong and it is an effective motivator, then why is the money to be saved by not buying the cigarettes, not motivation enough to quit? With cigarettes costing what they do now, even when they are self-rolled and/or bought from a good friend who happens to go abroad a lot, it wouldn’t take most people that long to save £400 by giving them up. Probably less than 9 months, put it that way.

So say it’s true that the vouchers will in most cases be spent on essentials that the mothers-to-be cannot otherwise afford, then why would the money saved by quitting, not have the same effect?

The other thing that didn’t jump out at me when I first heard about the idea but seems obvious now that it has occured to me, is that this idea seems to suggest that someone, somewhere, is labouring under the frankly pretty disturbing assumption that the significant majority of people who don’t give up smoking when pregnant, are those who are in a financial position to see £400 of shopping vouchers as a reason to do something that they wouldn’t have otherwise been capable of doing. What about the wealthy people who don’t give up? They surely won’t see £400 given to them in instalments as an added motivation, certainly not a strong enough one to help them battle an addiction that has been likened many times, in it’s addictiveness, to heroine.

So here’s what I think may be the most important question to ask about this research – is an assumption being made that smoking throughout pregnancy somehow correllates with an individual’s financial situation, or dare I suggest it, their social class?

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