Preliminary Test of Reactive Carrot Incentives in a Practice Quit Environment With Contingency Management Incentives

Study Overview
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Brief Summary
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The primary aim of this study is to pilot test a novel reactive carrot approach for improving individuals' ability to stick to a practice quit program in a smoking cessation context. In this study, the treatment gives subjects an offer to forego a monetary incentive to forego the opportunity to receive subsequent abstention (contingency management) rewards.

Detailed Description
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All the subjects, treatment and control groups, would be given the opportunity to receive attendance rewards for attending six CO testing meetings as well as abstention (contingency management) rewards for abstaining from smoking. The only difference between the subjects randomly assigned to treatment and control groups is that each member of the treatment group would be tempted at the beginning of their program by being offered a one-time monetary incentive to forego the opportunity to receive subsequent abstention (contingency management) rewards. Treatment group subjects would, at their initial intake meeting after the attendance and abstention rewards opportunity had been described, be given a one-time opportunity to received $80 temptation payment to give up the opportunity to receive subsequent abstinence (contingency management) rewards that could be worth as much as $165. Subjects who accepted this one-time opportunity would remain enrolled in the practice quit smoking and they would still be eligible to receive attendance reward compensation totaling up to $30 for showing up to their six testing appointments. The purpose of the study is to test whether resisting the temptation to accept the one-time payment helps steel the resolve of the treatment subjects to follow through and make sure that they earn the subsequent contingency management rewards. More specifically, an intent-to-treat design will allow us to test whether the temptation causes treatment group subjects to have greater success than the un-tempted control group subjects to abstain from smoking during the two-week practice quit period.

Official Title
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Preliminary Test of Reactive Carrot Incentives in a Practice Quit Environment With Contingency Management Incentives

Conditions
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Smoking Cessation

Intervention / Treatment
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* Behavioral: Contingency Management
* Behavioral: Control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 18 years Smoke ≥ 3 cigarettes per week and expressing interest in quitting smoking. Exclusion Criteria: Unstable psychiatric conditions such as suicidal ideation, acute psychosis, severe alcohol dependence, or dementia unstable medical conditions that have not been well controlled (e.g., acute infection requiring hospitalization) for the past 30 days pregnant or breastfeeding women those with limited decision making capacity.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Contingency Management<br>The treatment group will receive a onetime offer of $80 (a reactive carrot) to forego all abstinence (contingency management) reward payments in the future. | Behavioral: Contingency Management<br>* The treatment group will receive a onetime offer of $80 (a reactive carrot) to forego all abstinence (contingency management) reward payments in the future.<br>|
| Placebo Comparator: Control<br>The control group will receive contingency management payments and other monetary benefits for completing the trial. | Behavioral: Control<br>* The control group will receive contingency management payments and other monetary benefits for completing the trial.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Breath Carbon Monoxide Test (measured in ppm levels) | A primary outcome is the sum of times a subject tested abstinent at the 6 CO testing meetings. To test for abstinence, a breath carbon monoxide test will be used to determine exposure to smoke. Abstinence will be coded as expired-air carbon monoxide (CO) levels below 5 ppm. | 14 days following intake date | 
| Proportion of CO (CO ≤ 4ppm) | Proportion of 6 CO tests showing abstinence (CO ≤ 4ppm) | 14 days following intake date | 
| Maximum number of consecutive abstinent days | The maximum number of consecutive abstinent days for each subject will be measured | 14 days following intake date | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Attrition | Attrition will be measured by participants ability to make their testing appointments. | 14 days following intake date | 
| Contingency Management Payment | Total amount of abstention (contingency management) rewards paid to subjects. | 14 days following intake date | 
| Time to first relapse | Time to first relapse will be measured by subjects self-reporting use of different types of tobacco products or cigarette alternatives | 14 days following intake date | 
| Reduced smoking | Whether subjects report reduced smoking will be used to measure reduced smoking habits | 14 days following intake date, as well as 1 month and 6 months after intake date | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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incentives