Low-Cost Contingency Management for Smoking Cessation
Status:
Completed
Trial end date:
2012-05-01
Target enrollment:
Participant gender:
Summary
An innovative low-cost form of contingency management has been developed in which
participants receive the chance to draw vouchers from a fish bowl depending on whether or not
their abstinence from tobacco is confirmed by expired-air carbon monoxide. The vouchers can
be redeemed for prizes of varying value. This form of contingency management has been shown
to be effective in the treatment of a variety of substance use disorders, but has not been
investigated in a clinical trial focusing on smoking cessation. Thus, the primary purpose of
the proposed study will be to investigate the effects of a low-cost prize-based form of
contingency management in the treatment of nicotine dependence. To accomplish this objective,
we enrolled 103 current smokers into the study. The participants in Study Arm 1 received the
contingency management intervention for 8 weeks, and the participants in Study Arm 2 had
their smoking status assessed but did not receive the contingency management intervention.
Both interventions received brief counseling and nicotine replacement therapy. The counseling
was conducted in two 60-minute individual sessions scheduled one week apart with two
follow-up phone calls at weeks 3, 4, and 6.
The primary outcome for this study was biochemically-validated smoking status at 3 months
(end of treatment), and at 6- and 12-month follow-up. Both continuous and point-prevalent
abstinence rates were determined. Saliva cotinine levels were measured in all participants
reporting abstinence at each assessment. This study had 80% power to detect a 10% absolute
difference in smoking cessation rates between the two treatment conditions (i.e., a 28% quit
rate in Study Arm 1 versus a 18% quit rate in Study Arm 2) with alpha set at 0.05. These
estimates included an anticipated 15% loss to follow-up over the 12-month study period.