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

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.

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.