A  

Multiple economic evaluations have demonstrated that adding financial incentives to standard cessation support for pregnant smokers is highly cost-effective or even cost-saving. A UK trial reported an incremental cost of just £17 and a gain of 0.04 QALYs, yielding an ICER of £482/QALY—far below accepted thresholds [Boyd, 2016, PMID 26370095]. An updated analysis from the CPIT III multicentre trial found lifetime cost savings of £37 and a gain of 0.171 QALYs for mother-infant pairs, indicating the intervention is dominant (better outcomes at lower cost) [McMeekin, 2023, PMID 36843417]. Similar findings in a pooled U.S. dataset showed an ICER of $8,371/QALY and a benefit-cost ratio of 11.9:1 [Shepard, 2022, PMID 35533885]. Collectively, these studies support the conclusion that financial incentives are indeed cost-effective for promoting smoking cessation during pregnancy.