Treating Smokers in Substance Treatment With Contingent Vouchers, Nicotine Replacement and Brief Advice Adapted for Sobriety Settings
- PMID:27658756
- PMCID: PMC5154824
- DOI: 10.1016/j.jsat.2016.08.012
Treating Smokers in Substance Treatment With Contingent Vouchers, Nicotine Replacement and Brief Advice Adapted for Sobriety Settings
Abstract
Treatment for substance use disorders (SUD) provides an opportunity to use voucher-based treatment for smoking. Nicotine replacement (NRT) could improve outcomes previously observed with vouchers without NRT.
Methods: A randomized controlled trial compared contingent vouchers (CV) for smoking abstinence to noncontingent vouchers (NV), when all received counseling and NRT. Smokers who had not sought smoking treatment (n=340) in residential SUD treatment were provided 14days of vouchers for complete smoking abstinence per exhaled carbon monoxide (CO) after a 5-day smoking reduction period, or vouchers only for breath samples, plus brief advice (four sessions) and 8weeks of NRT.
Results: Within treatment, 20% had complete abstinence with CV, 5% with NV (p<.001), and participants showed 50% of days abstinent in CV compared to 22% in NV (p<.001). Across 1, 3, 6 and 12months after randomization, CV resulted in significantly fewer cigarettes per day (p<.01) and fewer days smoking (p<.01), but with small effects. Point-prevalence abstinence differences across follow-up (e.g., 4% CV, 2% in NV at 6 and 12months) were not significant. No differences in substance use were seen.
Conclusions: Within-treatment effects on abstinence are stronger than in a prior study of the same CV with BA but without NRT, but NRT does not improve abstinence after vouchers end. Implications for voucher-based treatment include investigating effects when combined with stronger smoking medications and using motivational interviewing. Smoking treatment does not harm SUD recovery.
Keywords: Brief advice; Contingency management; Contingent vouchers; Financial incentives; Nicotine dependence; Nicotine replacement; Point-prevalence abstinence; Smoking cessation; Substance use disorders.
Published by Elsevier Inc.
Figures
Similar articles
- Contingent vouchers and motivational interviewing for cigarette smokers in residential substance abuse treatment.Rohsenow DJ, Tidey JW, Martin RA, Colby SM, Sirota AD, Swift RM, Monti PM.Rohsenow DJ, et al.J Subst Abuse Treat. 2015 Aug;55:29-38. doi: 10.1016/j.jsat.2015.02.010. Epub 2015 Mar 12.J Subst Abuse Treat. 2015.PMID:25805668Free PMC article.Clinical Trial.
- Predictive Validity of a Cigarette Purchase Task in a Randomized Controlled Trial of Contingent Vouchers for Smoking in Individuals With Substance Use Disorders.Mackillop J, Murphy CM, Martin RA, Stojek M, Tidey JW, Colby SM, Rohsenow DJ.Mackillop J, et al.Nicotine Tob Res. 2016 May;18(5):531-7. doi: 10.1093/ntr/ntv233. Epub 2015 Oct 24.Nicotine Tob Res. 2016.PMID:26498173Free PMC article.Clinical Trial.
- Intolerance for withdrawal discomfort and motivation predict voucher-based smoking treatment outcomes for smokers with substance use disorders.Rohsenow DJ, Tidey JW, Kahler CW, Martin RA, Colby SM, Sirota AD.Rohsenow DJ, et al.Addict Behav. 2015 Apr;43:18-24. doi: 10.1016/j.addbeh.2014.12.003. Epub 2014 Dec 10.Addict Behav. 2015.PMID:25531536Free PMC article.Clinical Trial.
- [Smoking reduction and temporary abstinence: new approaches for smoking cessation].Le Houezec J, Säwe U.Le Houezec J, et al.J Mal Vasc. 2003 Dec;28(5):293-300.J Mal Vasc. 2003.PMID:14978435Review.French.
- Combined pharmacotherapy and behavioural interventions for smoking cessation.Stead LF, Lancaster T.Stead LF, et al.Cochrane Database Syst Rev. 2012 Oct 17;10:CD008286. doi: 10.1002/14651858.CD008286.pub2.Cochrane Database Syst Rev. 2012.Update in:Cochrane Database Syst Rev. 2016 Mar 24;3:CD008286. doi: 10.1002/14651858.CD008286.pub3.PMID:23076944Updated.Review.
Cited by
- Incentives for smoking cessation.Notley C, Gentry S, Livingstone-Banks J, Bauld L, Perera R, Hartmann-Boyce J.Notley C, et al.Cochrane Database Syst Rev. 2019 Jul 17;7(7):CD004307. doi: 10.1002/14651858.CD004307.pub6.Cochrane Database Syst Rev. 2019.Update in:Cochrane Database Syst Rev. 2025 Jan 13;1:CD004307. doi: 10.1002/14651858.CD004307.pub7.PMID:31313293Free PMC article.Updated.
- QuitNic: A Pilot Randomized Controlled Trial Comparing Nicotine Vaping Products With Nicotine Replacement Therapy for Smoking Cessation Following Residential Detoxification.Bonevski B, Manning V, Wynne O, Gartner C, Borland R, Baker AL, Segan CJ, Skelton E, Moore L, Bathish R, Chiu S, Guillaumier A, Lubman DI.Bonevski B, et al.Nicotine Tob Res. 2021 Feb 16;23(3):462-470. doi: 10.1093/ntr/ntaa143.Nicotine Tob Res. 2021.PMID:32770246Free PMC article.Clinical Trial.
- Cessation classification likelihood increases with higher expired-air carbon monoxide cutoffs: a meta-analysis.Karelitz JL, McClure EA, Wolford-Clevenger C, Pacek LR, Cropsey KL.Karelitz JL, et al.Drug Alcohol Depend. 2021 Apr 1;221:108570. doi: 10.1016/j.drugalcdep.2021.108570. Epub 2021 Feb 3.Drug Alcohol Depend. 2021.PMID:33592559Free PMC article.Review.
- Contingency management treatment for substance use disorders: How far has it come, and where does it need to go?Petry NM, Alessi SM, Olmstead TA, Rash CJ, Zajac K.Petry NM, et al.Psychol Addict Behav. 2017 Dec;31(8):897-906. doi: 10.1037/adb0000287. Epub 2017 Jun 22.Psychol Addict Behav. 2017.PMID:28639812Free PMC article.Review.
- KLHL3 single-nucleotide polymorphism is associated with essential hypertension in Chinese Han population.Li J, Hu J, Xiang D, Ji B, Xu S, Shi L, Zhao S.Li J, et al.Medicine (Baltimore). 2019 May;98(20):e15766. doi: 10.1097/MD.0000000000015766.Medicine (Baltimore). 2019.PMID:31096542Free PMC article.
References
- Asher MK, Martin RA, Rohsenow DJ, MacKinnon SV, Traficante R, Monti PM. Perceived barriers to quitting smoking among alcohol dependent patients in treatment. Journal of Substance Abuse Treatment. 2003;24:169–174. - PubMed
- Benowitz NL. Cotinine disposition and effects. Clinical and Pharmacology Therapeutics. 1983;34:604–611. - PubMed
- Bien TH, Burge R. Smoking and drinking: A review of the literature. International Journal of Addictions. 1991;25:1429–1454. - PubMed
Publication types
MeSH terms
Related information
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical