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Comparative Study
. 2015 Mar:42:86-90.
doi: 10.1016/j.addbeh.2014.11.009. Epub 2014 Nov 20.

Contingency management improves smoking cessation treatment outcomes among highly impulsive adolescent smokers relative to cognitive behavioral therapy

Meghan E Morean  1 , Grace Kong  2 , Deepa R Camenga  3 , Dana A Cavallo  2 , Kathleen M Carroll  4 , Brian Pittman  2 , Suchitra Krishnan-Sarin  2
Affiliations
Comparative Study

Contingency management improves smoking cessation treatment outcomes among highly impulsive adolescent smokers relative to cognitive behavioral therapy

Meghan E Morean et al. Addict Behav. 2015 Mar.

Abstract

Background: Impulsive adolescents have difficulty quitting smoking. We examined if treatments that provide behavioral incentives for abstinence improve treatment outcomes among impulsive adolescent smokers, who have been shown to be highly sensitive to reward.

Methods: We ran secondary data analyses on 64 teen smokers (mean age=16.36 [1.44]; cigarettes/day=13.97 [6.61]; 53.1% female; 90.6% Caucasian) who completed a four-week smoking cessation trial to determine whether impulsive adolescents differentially benefit from receiving cognitive behavioral therapy (CBT), contingency management (CM), or the combination of the two (CM/CBT). Indices of treatment efficacy included self-report percent days abstinent and end of treatment biochemically-confirmed 7-day point prevalence abstinence (EOT abstinence). We assessed self-reported impulsivity using the Brief Barratt Impulsiveness Scale. We used univariate Generalized Linear Modeling to examine main effects and interactions of impulsivity and treatment condition as predictors of self-reported abstinence, and exact logistic regression to examine EOT abstinence.

Results: CM/CBT and CM were comparably effective in promoting abstinence, so analyses were conducted comparing the efficacy of CBT to treatments with a CM component (i.e., CM and CM/CBT). CBT and deficient self-regulation predicted lower self-reported abstinence rates within the total analytic sample. Treatments containing CM were more effective than CBT in predicting 1) self-reported abstinence among behaviorally impulsive adolescents (% days abstinent: CM 77%; CM/CBT 81%; CBT 30%) and 2) EOT point prevalence abstinence among behaviorally impulsive adolescents and adolescents with significant deficits in self-regulation.

Conclusion: CM-based interventions may improve the low smoking cessation rates previously observed among impulsive adolescent smokers.

Keywords: Adolescent; Cognitive behavioral therapy; Contingency management; Impulsivity; Smoking cessation.

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Conflict of interest statement

Conflict of Interest

Drs. Morean, Kong, Camenga, Cavallo, Carroll, Krishnan-Sarin and Mr. Pittman declare that they have no actual or potential conflict of interest.

Figures

Figure 1
Figure 1
Treatment Containing a Contingency Management Component is Superior to Cognitive Behavioral Therapy for Individuals who are Behaviorally Impulsive
See this image and copyright information in PMC

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