A smartphone-based program uses financial rewards to improve smoking cessation rates among pregnant individuals in rural areas.
RT’s Three Key Takeaways:
- Digital Financial Incentives: A new smartphone-based treatment provides monetary rewards to pregnant individuals for verified smoking abstinence, aiming for FDA approval.
- Addressing Rural Disparities: The intervention targets rural communities where hospital closures and a lack of on-site services limit access to traditional perinatal smoking cessation programs.
- Remote Verification Technology: Participants use a mobile application to submit video evidence of nicotine tests, with funds delivered to a restricted debit card to ensure essential spending.
The National Institute on Drug Abuse (NIDA) has granted a multi-phase federal award to the University of Vermont to advance a smartphone-based treatment designed to help pregnant individuals quit smoking, according to a university news release.
Image: Using a smartphone application, participants submit videos of themselves completing salivary cotinine tests, which measure nicotine exposure. The system verifies smoking status and delivers money directly to a secure debit card. Credit: Stephen T. Higgins, Ph.D.
The funding supports further testing of a digital financial-incentives intervention that provides rewards for verified smoking abstinence. If trial outcomes support the effectiveness of the intervention, the treatment may be designated as an FDA approved digital intervention.
Cigarette smoking remains the leading preventable cause of poor pregnancy outcomes in the US, contributing to serious health risks for both mothers and infants, according to the news release. The burden is particularly high in rural communities, where pregnant individuals are more likely to smoke and often have limited access to evidence-based cessation programs.
“Widespread closures of rural hospital and a lack of on-site services means there are fewer clinic-based perinatal smoking cessation programs in the US,” said Stephen T Higgins, professor of psychiatry and director of the Vermont Center on Behavior and Health (VCBH), in a news release. “By transitioning to a remote digital therapeutic, we can bypass those limitations and deliver life-saving support directly to families who need it most.”
Using a smartphone application developed by DynamiCare Health, participants submit videos of themselves completing salivary cotinine tests, which measure nicotine exposure. The system verifies smoking status and delivers money directly to a secure debit card. The card is managed to prohibit spending on non-essential or restricted items, including alcohol, cannabis, and firearms.
Participant enrollment is scheduled to begin in summer 2026, using national remote recruitment strategies refined through previous randomized clinical trials.
Higgins and other researchers demonstrated in the 1990s that providing small financial rewards, such as vouchers redeemable for retail items, can increase healthy choices in treatment-recalcitrant populations. This work in contingency management provided one of the few efficacious clinical interventions to change human behavior, according to the news release. Previous studies by Higgins and colleagues have shown that incentive-based smoking cessation treatment improved cessation rates among pregnant people.
