Interactive Voice Response Technology to Mobilize Contingency Management for Smoking Cessation

Cigarette smoking remains the most common source of preventable morbidity and mortality in
the United States, with in excess of $167 billion in economic costs per year. Contingency
management (CM), in which tangible incentives are provided contingent on a target behavior
like abstinence, is highly efficacious in improving substance abuse treatment outcomes and
is receiving increased attention for smoking cessation. Expired carbon monoxide (CO) is the
most common objective smoking status test used in smoking research and treatment.
Unfortunately, multiple CO tests/day are typically required to detect all smoking and
reinforce sustained abstinence. The resulting logistical and resource limitations greatly
limit the application of this potentially powerful quit smoking toolset. This study
addresses these limitations by examining the effectiveness of using interactive voice
response technology (IVR) to implement CM. Smokers who want to quit (N = 90 randomized) will
receive 2 quit preparation sessions based on public health guidelines for smoking cessation
and set a target quit date. Participants will be randomly assigned to 1 of 2 treatment
conditions: (a) IVR-S consisting of objective smoking status monitoring using IVR, telephone
counseling and transdermal nicotine and (b) IVR-CM, consisting of the same monitoring,
telephone counseling and transdermal nicotine plus IVR-based CM for smoking abstinence. It
is hypothesized that abstinence rates will be higher in the IVR-CM condition compared to the
IVR-S, supporting a combined IVR CM approach, and thereby greatly increasing the
applicability of these powerful smoking cessation tools.