Contingent Vouchers and Motivational Interviewing for Cigarette Smokers in Residential Substance Abuse Treatment

Abstract

Residential drug treatment provides an opportunity to intervene with smokers substance use disorders (SUD). A randomized controlled clinical trial compared: (1) Contingent Vouchers (CV) for smoking abstinence to Noncontingent Vouchers (NCV), crossed with (2) Motivational Interviewing (MI) or Brief Advice (BA), for 184 smokers in SUD treatment. During the voucher period, 36% of carbon monoxide readings indicated smoking abstinence for those receiving CV versus 13% with NCV (p < .001). Post-treatment point-prevalence abstinence rates were low (3–4% at each follow up), with more abstinence when CV was combined with MI (6.6% on average) than with BA (0% on average). No differential effects on drug use or motivation to quit smoking occurred. Thus, CV had limited effects on long-term smoking abstinence in this population but effects were improved when CV was combined with MI. More effective methods are needed to increase motivation to quit smoking and quit rates in this high-risk population.

Internet-based incentives increase blood glucose testing with a non-adherent, diverse sample of teens with type 1 diabetes mellitus: a randomized controlled Trial

“…This procedure, known as Bcontingency management^(CM), has been used to treat substance abuse [8], increase asthma and HIV medication adherence [9][10][11], increase physical activity levels and facilitate weight loss [12,13], and improve diabetes self-management in children and adolescents [14][15][16]. Contingency management has also been shown to be more effective when combined with other psychosocial interventions, such as motivational interviewing (MI) [17].…”

Intolerance for withdrawal discomfort and motivation predict voucher-based smoking treatment outcomes for smokers with substance use disorders

“…Participants were 184 smokers recruited from a 28-day inner city residential substance treatment program for a study of contingent vouchers plus counseling on smoking abstinence (Rohsenow et al, submitted). Participants did not need to want to quit smoking to be recruited.…”

“…Both counseling methods were manualized motivational approaches adapted to address sobriety issues (see Rohsenow et al, submitted, for full description and outcome). Participants were told not to use pharmacotherapy for smoking during the voucher period (to avoid confounds with differential medication use) but free nicotine replacement (patch or gum) was available on request afterwards.…”

Barriers to Quitting Smoking Among Substance Dependent Patients Predict Smoking Cessation Treatment Outcome

“…Participants were 184 smokers with SUD in 28-day residential substance treatment participating in a larger study (Rohsenow et al, 2015) who had smoked 10 or more cigarettes per day for the past 6 months. As part of the larger study participants were enrolled in smoking counseling (4 sessions of brief advice or motivational interviewing with coping skills discussions) with half randomized to contingency management for smoking cessation (19 days), and half randomized to non-contingent payments.…”

“…Participants did not need to be motivated to quit smoking to participate. In the study, all received smoking counseling (4 weeks of brief advice, same as in Rohsenow et al, 2015) and transdermal nicotine replacement for 8 weeks, with half randomized to contingency management for smoking cessation and half to noncontingent payments. The research procedures were approved by the Institutional Review Board of Brown University.…”