Date of Award

8-2015

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Dr. Cynthia J. Pietras

Second Advisor

Dr. Alan Poling

Third Advisor

Dr. Scott Gaynor

Fourth Advisor

Dr. Jesse Dallery

Keywords

Contingency management, smoking, salilvacotinine, delay-discounting, abstinence, smokingcessation treatments

Abstract

Contingency management decreases smoking by delivering monetary incentives contingent upon objective verification of abstinence. The present study investigated the effectiveness of monitoring saliva cotinine twice weekly in a contingency-management treatment for cigarette smoking using a cash prize-based payment system. Participants were randomly assigned to either a contingent reinforcement group or a non-contingent reinforcement group. The study began with five consecutive Baseline days during which participants smoked as usual, and was followed by four consecutive Shaping days, during which participants were asked to gradually decrease smoking. During the subsequent three-week Abstinence phase, participants submitted saliva cotinine and breath carbon monoxide samples twice per week. For the contingent group, meeting abstinence criteria earned draws from a cash prize-bowl. Participants in the non-contingent reinforcement group earned a set number of draws each visit. Participants also completed a brief computerized delay-discounting test each visit to measure the effects of nicotine abstinence on impulsivity. Sixteen participants completed the study. Saliva cotinine measures significantly correlated with breath CO measures and aligned with self-reports of smoking. Smoking levels decreased in both groups. However, this decrease was observed only in sessions attended and may not have occurred when sessions were missed. There was not a group difference in changes in smoking. Attendance rates significantly decreased when the frequency of monitoring decreased to twice per week. These results suggest that twice weekly monitoring of saliva cotinine is an easy and effective way to monitor smoking in a contingency-management smoking cessation program. However, infrequent monitoring may limit treatment efficacy and require additional program modifications, such as higher payment. The decrease in smoking in the non-contingent group may have been due to the instructions and feedback given, and warrants additional research in this area. Baseline carbon monoxide level was the only predictor of days abstinent. Scores on the Fagerstrom Test for Nicotine Dependence were predictive of baseline CO and cotinine levels, but not changes in smoking. Impulsivity did not change throughout the study, and baseline impulsivity measures were not predictive of abstinence. Additional delay-discounting research using various reward types, in which delay–discounting is measured across short- and long-term nicotine abstinence is necessary to better investigate the relationship between nicotine and impulsivity.

Access Setting

Dissertation-Campus Only

Restricted to Campus until

8-15-2025

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