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Randomized Controlled Trial
. 2017 May;112(5):875-883.
doi: 10.1111/add.13715. Epub 2017 Jan 25.

Nationwide access to an internet-based contingency management intervention to promote smoking cessation: a randomized controlled trial

Jesse Dallery  1   2 , Bethany R Raiff  3 , Sunny Jung Kim  4 , Lisa A Marsch  4 , Maxine Stitzer  5 , Michael J Grabinski  6
Affiliations
Randomized Controlled Trial

Nationwide access to an internet-based contingency management intervention to promote smoking cessation: a randomized controlled trial

Jesse Dallery et al. Addiction. 2017 May.

Abstract

Background and aims: Contingency management (CM) is one of the most effective behavioral interventions to promote drug abstinence, but availability of this treatment is limited. We evaluated the efficacy and acceptability of internet-based CM relative to an internet-based monitoring and goal-setting control group in a nationwide sample of cigarette smokers.

Design: Randomized controlled trial with 3- and 6-month follow-ups.

Setting: United States.

Participants: Smokers (n = 94) from 26 states were enrolled (mean age 36, 56% female).

Intervention and comparator: Participants were randomized to earn financial incentives (up to $480 over 7 weeks) based on video-verified abstinence using breath carbon monoxide (CO) output (n = 48; abstinent contingent group, AC), or based on submitting CO samples (n = 46, submission contingent, SC). Both groups also received the same CO-based goals. A $50 deposit was required in both groups that could be recouped from initial earnings.

Measures: The primary outcome was point prevalence at week 4. Secondary outcomes were point prevalence at the 3- and 6-month follow-ups, percentages of negative CO samples, adherence to the CO sampling protocol, and treatment acceptability ratings on a 0-100-mm visual analog scale.

Findings: Abstinence rates differed at 4 weeks between the AC (39.6%) and SC (13.0%) groups [odds ratio (OR) = 4.4, 95% confidence interval (CI) = 1.6-12.3], but not at the 3- (29.2% AC and 19.6% SC, OR = 1.7, 95% CI = 0.6-4.4) or 6- (22.9% AC and 13.0% SC, OR = 2.0, 95% CI = 0.7-5.9) month follow-ups. During the two main treatment phases, there were significant differences in negative COs (53.9% AC and 24.8% SC, OR = 3.5, 95% CI = 3.1-4.0; 43.4% AC and 24.6% SC, OR = 2.3, 95% CI = 1.6-3.4). Adherence to the CO submission protocol was equivalent (78% AC and 85% SC, difference = 7.0%, 95% CI = -10.3 to 23.8 %, F < 1, P = 0.39). The lowest acceptability ratings were for the items assessing the deposit, whereas the highest ratings concerned the ease of the intervention, the graph of CO results, and earning money.

Conclusions: A contingency management/financial incentive program delivered via the internet improved short-term abstinence rates compared with an internet program without the incentives.

Keywords: Cigarette smoking; contingency management; deposit contract; financial incentives; technology; treatment.

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Conflict of interest statement

Declarations of interest

None.

Figures

Figure 1
Figure 1
CONSORT flow diagram.
See this image and copyright information in PMC

References

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