The effects of percentile versus fixed criterion schedules on smoking with equal incentive magnitude for initial abstinence.

Abstract

Incentives have been successfully used to reduce smoking in hard-to-treat (HTT) smokers by progressively reinforcing lower levels of breath carbon monoxide (CO). When compared to schedules only providing incentives for smoking abstinence, using a progressive (percentile) criterion facilitates longer periods of smoking abstinence. However, participants receiving incentives for lower breath CO levels on percentile schedules typically earn more for their first abstinent breath CO sample, relative to participants receiving incentives only for smoking abstinence. Many studies show that larger incentive magnitude increases abstinence rates. The present study tested the effects of different incentive schedules on rates of abstinence maintenance while holding the initial incentive magnitude constant for 93 HTT smokers to eliminate initial abstinence incentive magnitude as a potential confound. Smokers were randomized to percentile, fixed criterion, or random incentive schedules. The incentive magnitude for the first abstinent breath CO sample (< 3 ppm) was $5.00 for percentile and fixed criterion incentive participants, and then increased by $0.50 for each consecutive abstinent breath CO sample. All groups had similar patterns of meeting the abstinence criterion for at least one visit. However, once this abstinence criterion was met, abstinence was more likely to be maintained by fixed criterion incentive participants. Unlike previous studies comparing percentile and fixed criterion schedules, percentile incentive schedules were not associated with longer periods of abstinence, relative to fixed criterion incentive schedules. Further studies that manipulate initial incentive magnitude are needed to test whether the difference between the current and previous studies was due to initial incentive magnitude.

The effects of fixed versus escalating reinforcement schedules on smoking abstinence

“…Participants who delivered at least one breath CO sample <3 ppm were classified as ES. Those participants who did not produce a breath CO sample <3 ppm were considered hard to treat and were enrolled in an alternative CM smoking-cessation study (Romanowich & Lamb, 2014). Immediately after the five-visit abstinence trial, ES participants were randomly assigned to one of three groups: escalating reinforcement schedule, fixed reinforcement schedule, or control.…”

Technology‐based contingency management and e‐cigarettes during the initial weeks of a smoking quit attempt

“…Although it is unknown if a shaping phase (as arranged in previous studies) would generate greater abstinence than an abrupt transition to abstinence, some research suggests that alternative methods to shape abstinence hold promise (Lamb et al, ; cf. Romanowich & Lamb, ).…”

A Text Message Intervention with Adaptive Goal Support to Reduce Alcohol Consumption Among Non-Treatment-Seeking Young Adults: Non-Randomized Clinical Trial with Voluntary Length of Enrollment

“…We focused on goal support, given the importance of goals in behavior change generally [ 25 ] and for self-regulation of substance use among young adults specifically [ 26 ]. Although there have been no prior alcohol interventions that use adaptive goal prompts, behavioral studies outside the alcohol field have used adaptive goal algorithms to improve step counts among obese adults [ 27 ] and reduce smoking by using a criterion based on percentile carbon monoxide levels [ 28 ].…”