Scholarships trialled to get Maori nursing students to quit smoking

Offering a cash scholarship as incentive for Maori nursing students to stop smoking has been trialled by an Auckland institute and an anti-smoking organisation says incentives are proving to be an effective tool.

Manukau Institute of Technology Maori faculty leader and nursing lecturer Evelyn Hikuroa conducted a pilot study to assess whether offering a monetary incentive to stop smoking would help people give up, the results of which were published in Nursing Praxis in New Zealand: Journal of Professional Nursing in March.

Co-author of the study and Massey University School of Public Health Associate Professor Marewa Glover said the study showed the incentive did help to a degree.

"We found that the student nurses were highly motivated to stop smoking for their own health, their family and their new career. Providing a cash incentive boosted that, especially because studying can be a financial strain for students," she said.

Twelve Maori nursing students at the Manukau Institute of Technology signed up for the study and seven made it through the final four weeks smokefree. Each student was required to get a family member or friend who also smoked to take part in the programme with them.

Two students and their family members stopped smoking at the start and remained smoke-free for the 24 weeks of the trial. Those two students received $1000 each.

Another student and their partner quit by week three and had not started smoking again by the conclusion of the trial. That student received $950.

Another four students and their family member relapsed at some point during the trial but were smokefree by the end.

Hikuroa said the number of Maori students in the nursing programme was low and most of them smoked.

Nurses who smoked often found there was conflict within themselves when it came to encouraging patients to quit, she said.

"They are likely to downplay the effects of smoking...and live with guilt and hypocrisy."

She said the trial found the cash incentive may have been a trigger for some students to join the programme and was seen as a bonus for many, but most students already wanted to quit.

Hikuroa said she was about to start a follow-up study to find out what the smoking habits of the participants was like two years after the initial study.

Glover had also run two other trials using incentives to encourage pregnant women to stop smoking and said her research had found it definitely worked for some people.

Incentives often helped to reduce barriers to quitting like the cost of seeing a doctor or the time needed to go to an assessment and made the experience more positive, she said.

Action on Smoking and Health New Zealand programme manager Boyd Broughton said two other studies looking at using incentives to help smokers quit had just been completed and the results were being collated.

On first appearance both trials seemed to support the idea that incentives were helpful if offered alongside support.

"If you can incentivise it right, it doesn't have to be money," he said.

Giving up

Nurse Cheri Phillips, 56, had been smoking on and off for about 35 years but has not touched a cigarette since she took part in the pilot study at Manukau Institute of Technology run by Evelyn Hikuroa about two years ago.

She was studying to be a nurse at the time and signed up for the programme for her health, her family and her career.

"To be a nurse, one of the big initiatives now is smoking cessation. You look like a bit of a hypocrite to be talking about it then go out the back and light up," she said.

Phillips convinced her husband, who smoked about two packets of cigarettes a week, to take part too and despite his initial doubts he managed to give up.

She said there was more behind her decision to quit than the cash incentive.

"[The money] was a bonus but for me it wasn't the reason to give up," she said.

Phillips said she now felt healthier and was better equipped to help the patients she worked with at Whanau Ora to give up smoking.