The aim of this research is to try and find out which incentives (financial or non-financial), if any, are most likely to help women to stop smoking in pregnancy (and not restart) and to breastfeed their babies until 6 months, to benefit the health of both mothers and babies.   There are three stages to BIBS:

Stage 1. We will synthesize the evidence for incentives delivered to women, families and NHS or non NHS providers and their associated theories of behaviour change, using focused research questions to inform the design of a trial. This will produce: i) evidence synthesis reports ii) a taxonomy of incentive characteristics, behaviour change theory, mechanisms of action and the barriers/facilitators to stopping smoking in pregnancy and breastfeeding iii) a short list of promising incentives.

Stage 2. For the incentive short-list we will investigate recipient, provider and public acceptability and any unintended effects. Mixed method data will refine the incentive characteristics, timing, quantity, delivery processes, recipient monitoring, organisational, environmental and contextual factors that are likely to increase effectiveness.

Stage 3. A Discrete Choice Experiment will refine the most promising intervention(s) to trial. The DCE will identify the relative probabilities of behaviour change for different types and level of incentive intervention and inform effect sizes. If probabilities vary across individuals with different characteristics, and affect outcomes, then a range of incentives may be more effective than a ‘one-size-fits-all’ approach. Combining all aspects of this study will enable us to define a trial intervention, recruitment and delivery strategies, provide a sample size calculation, model effect sizes and define outcome measurements. This will inform the design of a trial.

For more information see:

For the complete report see: 


Dr Heather Morgan;




Morgan H, Hoddinott P, Thomson G, Crossland N, Farrar S, Yi D, Hislop J, Hall Moran V, MacLennan G, Dombrowski SU, Rothnie K, Stewart F, Bauld L, Ludbrook A, Dykes F, Sniehotta FF, Tappin D, Campbell M. Benefits of incentives for breastfeeding and smoking cessation in pregnancy (BIBS): a mixed methods study to inform trial design. [in press]. Health Technology Assessment 2014.

Crossland, N., Thomson, G., Morgan, H., MacLennan, G., Campbell, M., Dykes, F. & Hoddinott, P. (2016). 'Breast pumps as an incentive for breastfeeding: a mixed methods study of acceptability'. Maternal and Child Nutrition, vol 12, no. 4, pp. 726-739. [Online] DOI: 10.1111/mcn.12346 [Online] AURA: Crossland_et_al_2016_Maternal_Child_Nutrition.pdf

Morgan, H., Thomson, G., Crossland, N., Dykes, F., Hoddinott, P. & ‘BIBS’ study team (2016). 'Combining PPI with qualitative research to engage ‘harder-to-reach’ populations: service user groups as co-applicants on a platform study for a trial'. Research Involvement and Engagement, vol 2, 7, pp. 1-26. [Online] DOI: 10.1186/s40900-016-0023-1 [Online] AURA: art_3A10.1186_2Fs40900_016_0023_1.pdf

Hoddinott, P., Thomson, G., Morgan, H., Crossland, N., MacLennan, G., Dykes, F., Stewart, F., Bauld, L. & Campbell, MK. (2015). 'Perspectives on financial incentives to health service providers for increasing breastfeeding and smoking quit rates during pregnancy: a mixed methods study'. BMJ Open, vol 5, no. 11, e008492. [Online] DOI: 10.1136/bmjopen-2015-008492 [Online] AURA: BMJ_Open_2015_Hoddinott_.pdf

Morgan, H., Hoddinott, PM., Thomson, G., Crossland, N., Farrar, S., Yi, D., Hislop, JM., Hall Moran, V., MacLennan, GS., Dombrowski, SU., Rothnie, KJ., Stewart, F., Bauld, L., Ludbrook, A., Dykes, F., Sniehotta, FF., Tappin, D. & Campbell, MK. (2015). 'Benefits of incentives for breastfeeding and smoking cessation in pregnancy (BIBS): a mixed methods study to inform trial design'. Health Technology Assessment, vol 19, no. 30. [Online] DOI: 10.3310/hta19300 

Crossland, N., Thomson, G., Morgan, H., Dombrowski, SU. & Hoddinott, P. (2015). 'Incentives for breastfeeding and for smoking cessation in pregnancy: An exploration of types and meanings'. Social Science & Medicine, vol 128, pp. 10-17. [Online] DOI: 10.1016/j.socscimed.2014.12.019 [Online]AURA: 1_s2.0_S0277953614008272_main.pdf

Hall Moran, V., Morgan, H., Rothnie, K., MacLennan, G., Stewart, F., Thomson, G., Crossland, N., Tappin, D., Campbell, M. & Hoddinott, P. (2015). 'Incentives to Promote Breastfeeding: A Systematic Review'. Pediatrics, vol 135, no. 3, pp. e687-702. [Online] DOI: 10.1542/peds.2014-2221

Thomson, G., Morgan, H., Crossland, N., Bauld, L., Dykes, F., Hoddinott, P. & BIBS team (2014). 'Unintended Consequences of Incentive Provision for Behaviour Change and Maintenance around Childbirth'. PLoS ONE, vol 9, no. 10, e111322. [Online]DOI:10.1371/journal.pone.0111322 [Online] AURA: Thomson2014.pdf

Hoddinott, P., Morgan, H., MacLennan, G., Sewel, K., Thomson, G., Bauld, L., Yi, D., Ludbrook, A. & Campbell, MK. (2014). 'Public acceptability of financial incentives for smoking cessation in pregnancy and breast feeding: a survey of the British public'. BMJ Open, vol 4, no. 7, e005524. [Online] DOI: 10.1136/bmjopen-2014-005524 [Online]AURA:Public_acceptability_of_...y_of_the_British_public.pdf