Contingency Management, Quitting Smoking, and ADHD
Status:
Completed
Trial end date:
2017-12-08
Target enrollment:
Participant gender:
Summary
The overall goal of the study is to evaluate how motivation and readiness for change are
influenced in the context of a smoking cessation attempt. A total of 60 adult (i.e. age
18-55) smokers (N=40 with ADHD; N=20 without ADHD) who are interested in quitting will be
enrolled into a 3-arm trial allocated as follows. Twenty of the ADHD smokers and the 20
non-ADHD smokers will be assigned to a traditional 8-week contingency management intervention
in which monetary payments will be made contingent upon biologically verified evidence of
smoking abstinence. The 20 additional ADHD smokers will be assigned to a treatment-as-usual
condition (nicotine replacement; supportive counseling). During the treatment phase, subjects
will be required to answer questions 4x/week in their daily lives via an EMA (Ecological
Momentary Assessment).
Specific Aim 1: To assess motivation to quit smoking and readiness for change prior to a quit
attempt in treatment seeking ADHD and non-ADHD smokers. Hypothesis 1a: The investigators
hypothesize that prior to a quit attempt, smokers with ADHD will exhibit significantly lower
levels of intrinsic motivation to quit, and equal or higher levels of extrinsic motivation to
quit compared to smokers without ADHD. Hypothesis 1b: The investigators hypothesize that
smokers with ADHD will exhibit relatively less readiness for change than smokers without
ADHD.
Specific Aim 2: To assess how baseline levels of motivation to quit and readiness for change
are influenced during a quit attempt as a function of both ADHD status and treatment
modality. Hypothesis 2a. The investigators hypothesize that the CM intervention will result
in relatively greater change in extrinsic motivation to quit versus intrinsic motivation to
quit, and that this effect will be more pronounced among ADHD smokers. Hypothesis 2b: The
investigators hypothesize that overall motivation to quit (intrinsic and extrinsic) and
readiness for change will be significantly influenced by the CM intervention versus treatment
as usual among ADHD smokers.
Exploratory Aim 1: To assess the relative efficacy of a CM intervention versus treatment as
usual in smokers with ADHD. The investigators hypothesize that CM will be more effective for
promoting short-term (4-8 weeks) smoking abstinence, as well as for promoting longer-term
(3-6 months) smoking cessation.
Exploratory Aim 2: To assess the associations among smoking withdrawal/craving, affect, ADHD
symptoms, and motivation to quit/readiness for change. The investigators hypothesize that
higher levels of motivation and readiness for change will be associated with lower levels of
self-reported withdrawal, craving, and negative affect.