Contingency Management for Smoking in Substance Abusers
| Status: | Completed |
|---|---|
| Conditions: | Smoking Cessation, Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology, Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 1/25/2019 |
| Start Date: | October 2008 |
| End Date: | April 2014 |
Contingent Vouchers for Smoking in Substance Abusers as Adjunct to Nicotine Patch
The aim of this study is to determine whether contingent reinforcement for smoking
abstinence, compared to noncontingent reinforcement, increases the effectiveness of brief
counseling and nicotine replacement on smoking abstinence of substance abusers in residential
treatment.
abstinence, compared to noncontingent reinforcement, increases the effectiveness of brief
counseling and nicotine replacement on smoking abstinence of substance abusers in residential
treatment.
Substance abusers have a high prevalence and rate of smoking with little success in quitting,
so stronger approaches are needed to encourage attempts to quit smoking.
The aim of this study is to determine whether contingent reinforcement for smoking abstinence
(CM), compared to noncontingent reinforcement (NR), increases the effectiveness of brief
counseling and nicotine replacement on smoking abstinence of substance abusers in residential
treatment. The proposed study will be a 2-group design in which up to 274 substance abusers
who smoke 10 or more cigarettes per day receive brief advice (4 sessions) and nicotine
replacement (NRT) (8 weeks), and are randomized to 19 days of CM for smoking vs. a matched NR
condition. The brief advice is adapted slightly for sobriety settings. Point-prevalence
abstinence will be assessed at 1, 3, 6 and 12 months after starting treatment. Secondary aims
evaluate effects of CM on substance use outcomes and potential mediators of effects on
outcome, including within-treatment abstinence, motivation level and tolerance for smoking
discomfort.
The significance is to add knowledge about the most effective ways to maximize smoking
cessation among substance abusers, important given that no methods are known to work with
this population.
so stronger approaches are needed to encourage attempts to quit smoking.
The aim of this study is to determine whether contingent reinforcement for smoking abstinence
(CM), compared to noncontingent reinforcement (NR), increases the effectiveness of brief
counseling and nicotine replacement on smoking abstinence of substance abusers in residential
treatment. The proposed study will be a 2-group design in which up to 274 substance abusers
who smoke 10 or more cigarettes per day receive brief advice (4 sessions) and nicotine
replacement (NRT) (8 weeks), and are randomized to 19 days of CM for smoking vs. a matched NR
condition. The brief advice is adapted slightly for sobriety settings. Point-prevalence
abstinence will be assessed at 1, 3, 6 and 12 months after starting treatment. Secondary aims
evaluate effects of CM on substance use outcomes and potential mediators of effects on
outcome, including within-treatment abstinence, motivation level and tolerance for smoking
discomfort.
The significance is to add knowledge about the most effective ways to maximize smoking
cessation among substance abusers, important given that no methods are known to work with
this population.
Inclusion Criteria:
- diagnosis of substance abuse or dependence by DSM-IV criteria
- in residential treatment at one particular agency
- currently smoking at least 10 cigarettes per day for the past 6 months
Exclusion Criteria:
- hallucinating or delusional or marked organic impairment (to the point of impairing
ability to understand informed consent) according to medical records
- current use of nicotine replacement therapy, Zyban, or any other smoking cessation
treatment
- medical exclusions for NRT: pregnant or nursing; treatment in the last 3 months for
unstable angina, severe congestive heart failure, uncontrolled hypertension; lung
cancer; supplemental oxygen; history of adverse reactions to NRT; allergies to
adhesive; or any severe skin disease that requires treatment (e.g., psoriasis or
eczema).
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