A pilot study on voucher-based incentives to promote abstinence from cigarette smoking during pregnancy and postpartum

Department of Psychology , University of Vermont, Burlington, Vermont, United States
Nicotine & Tobacco Research (Impact Factor: 3.3). 01/2005; 6(6):1015-20. DOI: 10.1080/14622200412331324910
Source: PubMed


We report results from a pilot study examining the use of vouchers redeemable for retail items as incentives for smoking cessation during pregnancy and postpartum. Of 100 study-eligible women who were still smoking upon entering prenatal care, 58 were recruited from university-based and community obstetric practices to participate in a smoking cessation study. Participants were assigned to either contingent or noncontingent voucher conditions. Vouchers were available during pregnancy and for 12 weeks postpartum. In the contingent condition, vouchers were earned for biochemically verified smoking abstinence. In the noncontingent condition, vouchers were earned independent of smoking status. Abstinence monitoring and associated voucher delivery was conducted daily during the initial 5 days of the cessation effort, gradually decreased to every other week antepartum, increased to once weekly during the initial 4 weeks postpartum, and then decreased again to every other week for the remaining 8 weeks of the postpartum intervention period. Contingent vouchers increased 7-day point-prevalence abstinence at the end-of-pregnancy (37% vs. 9%) and 12-week postpartum (33% vs. 0%) assessments. That effect was sustained through the 24-week postpartum assessment (27% vs. 0%), which was 12 weeks after discontinuation of the voucher program. Total mean voucher earnings across antepartum and postpartum were 397 US dollars (SD=414 US dollars) and 313 US dollars (SD=142 dollars) in the contingent and noncontingent conditions, respectively. The magnitude of these treatment effects exceed levels typically observed with pregnant and recently postpartum smokers, and the maintenance of effects through 24 weeks postpartum extends the duration beyond those reported previously.

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    • "In-treatment variables have also been identified as predictors of long-term abstinence. Previous research has shown that prior smoking abstinence during treatment can directly influence subsequent efforts to abstain from smoking (Heil, Alessi, Lussier, Badger, & Higgins, 2004), suggesting that smoking treatment programs could be optimized by targeting this specific behavior (Romanowich & Lamb, 2010b). Furthermore, consecutive abstinence throughout and at end-of-treatment, and attending more sessions during the treatment are factors commonly related to a higher chance of success in quitting (Dorner et al., 2011; Romanowich & Lamb, 2010b). "
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    ABSTRACT: 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.
    International Journal of Clinical and Health Psychology 06/2015; 12. DOI:10.1016/j.ijchp.2015.05.003 · 2.79 Impact Factor
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    • "Incentive type Examples Study a Vouchers and / or cash Cash , shopping vouchers range US $ 5 < $ 250 Donatelle et al . , 2000 ; Heil et al . , 2008 ; Higgins et al . , 2004 ; Mantzari et al . , 2012 ; Gadomski et al . , 2011 ; Cinciripini et al . , 2010 ; Lillington et al . , 1995 ; Edwards et al . , 2009 ; Nichter et al . , 2007 ; Ripley - Moffitt et al . , 2008 ; Radley et al . , 2013 ; Finch and Daniel , 2002 ; Wolfberg et al . , 2004 ; Hill , 1987"
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    ABSTRACT: Financial or tangible incentives are a strategy for improving health behaviours. The mechanisms of action of incentives are complex and debated. Using a multidisciplinary integrated mixed methods study, with service-user collaboration throughout, we developed a typology of incentives and their meanings for initiating and sustaining smoking cessation in pregnancy and breastfeeding. The ultimate aim was to inform incentive intervention design by providing insights into incentive acceptability and mechanisms of action.
    Social Science & Medicine 12/2014; 128C:10-17. DOI:10.1016/j.socscimed.2014.12.019 · 2.89 Impact Factor
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    • "Twenty individually randomised controlled trials [35,37,38,41,43,45,46,48–51,56–64], six cluster randomised controlled trials [40,42,52–55], and four non-randomised controlled trials (which used quasi-randomisation methods) [36,39,44,47] were identified. The majority of studies (n = 20) were conducted in the United States [35–38,41,43,45–47,50,51,54,56–59,61–64], with five studies conducted in the United Kingdom [39,42,49,53,60], two in the Netherlands [40,44], and one study each conducted in Poland [55], Canada [48], and New Zealand [52]. "
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    ABSTRACT: Background To facilitate translation of evidence into clinical practice, it is critical that clear, specific, and detailed information about interventions is provided in publications to promote replication, appropriate aggregation in meta-analysis, and implementation. This study examined whether twenty elements of interventions deemed essential for such translational application were reported in sufficient detail in smoking cessation trials with pregnant women.Methods Searches of electronic databases using MeSH terms and keywords identified peer-reviewed English language studies published between 2001 and 2012. Eligible studies reported a smoking cessation intervention targeted at pregnant women and met Cochrane¿s Effective Practice and Organization of Care group study design criteria. Each intervention arm of eligible studies was assessed against the developed twenty criteria.ResultsThirty relevant studies reported the findings of 45 intervention arms. The mode of delivery of the intervention was reported in 100% of intervention arms. Other well-reported criteria included reporting of the provider who delivered the intervention (96%), sample characteristics (80%), and the intervention setting (80%). Criteria not reported adequately included care provided to women who relapse (96% not reported), details about training given to providers (77% not reported), and the method of quit advice advised (76% not reported). No studies reported 100% of relevant criteria.Conclusions Current standards of reporting of intervention content and implementation are suboptimal. The use of smoking cessation specific checklists for reporting of trials, standard reporting using behaviour change taxonomies, and the publication of protocols as supplements should be considered as ways of improving the specificity of reporting.
    Implementation Science 08/2014; 9(1):94. DOI:10.1186/s13012-014-0094-z · 4.12 Impact Factor
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