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. 2016 Jan-Apr;16(1):30-38.
doi: 10.1016/j.ijchp.2015.05.003. Epub 2015 Jun 6.

Voucher-based contingency management and in-treatment behaviors in smoking cessation treatment

Carla López-Núñez  1 , Víctor Martínez-Loredo  1 , Sara Weidberg  1 , Irene Pericot-Valverde  1 , Roberto Secades-Villa  1
Affiliations

Voucher-based contingency management and in-treatment behaviors in smoking cessation treatment

Carla López-Núñez et al. Int J Clin Health Psychol. 2016 Jan-Apr.

Abstract
in English, Spanish

A high percentage of patients relapse within months following an attempt to quit smoking. For this reason, greater understanding of the determinants of successful smoking cessation is needed. The present study assessed the effect of Contingency Management (CM) combined with Cognitive-Behavioral Treatment (CBT) on certain in-treatment behaviors (treatment retention, in-treatment smoking abstinence, and weekly decrease of cotinine levels) and examined the effects of these in-treatment behaviors on smoking status at a 6-month follow-up. A total of 154 treatment-seeking patients in a community setting were randomly assigned to a CBT, CBT plus CM for Abstinence (CMA) or to a CBT plus CM for Shaping cessation (CMS) group. Both CBT + CM procedures improved the in-treatment behaviors compared to CBT alone. These in-treatment behaviors (particularly in-treatment smoking abstinence) were associated with long-term abstinence. The effect of CM on in-treatment behaviors may partially explain the positive long-term outcomes of this procedure. Our findings extend previous knowledge about the effect of CM on smoking behavior.

Un alto porcentaje de pacientes recae en cuestión de meses después de un intento para dejar de fumar. Por esta razón, es necesaria una mayor comprensión de los determinantes del éxito para dejar de fumar. Este estudio evaluó el efecto del Manejo de Contingencias (MC) combinado con un Tratamiento Cognitivo-Conductual (TCC) sobre ciertas conductas intra-tratamiento (tasas de retención, abstinencia durante el tratamiento y reducción semanal de los niveles de cotinina) y examinó los efectos de estas conductas sobre el consumo de tabaco a los 6 meses de seguimiento. Un total de 154 pacientes que buscaban tratamiento en un entorno comunitario fueron asignados aleatoriamente a TCC, TCC más MC para Abstinencia (MCA) o TCC más MC con Moldeamiento (MCM). Ambos procedimientos de TCC + MC mejoraron las conductas intra-tratamiento en comparación con TCC solo. Estas conductas (particularmente abstinencia durante el tratamiento) se asociaron con la abstinencia a largo plazo. El efecto del MC sobre las conductas intra-tratamiento puede explicar parcialmente los resultados positivos a largo plazo de este procedimiento. Nuestros hallazgos amplían el conocimiento previo acerca del efecto del MC sobre la conducta de fumar.

Keywords: Contingency management; Experimental study; In-treatment behaviors; Smoking.

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Figures

Figure 1
Figure 1
Participants Flow Diagram.
Figure 2
Figure 2
In-treatment outcomes over the 6-week intervention. Note. CBT = Cognitive-Behavioral Treatment; CBT + CMA = Cognitive-Behavioral Treatment plus Contingency Management for Abstinence; CBT + CMS = Cognitive-Behavioral Treatment plus CM for Shaping cessation.
See this image and copyright information in PMC

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