Addressing response requirements and behavioral costs in contingency management for smoking cessation

Despite the efficacy of contingency management (CM) in promoting smoking reduction and abstinence, major barriers continue to hinder its widespread dissemination and adoption. The present study addressed two of these barriers, inefficient response requirements and high behavioral costs, by evaluating a novel payment schedule implemented within a workplace setting. Nine university staff were enrolled in a 6-week ABAB study design. During baseline weeks, participants earned money contingent on session attendance. During CM weeks, participants earned money contingent on smoking reduction or abstention payment arrangements, which were available concurrently. Abstention payments increased in magnitude across treatment weeks whereas reduction payments decreased. The results indicate that participants’ biological and self-report measures of smoking did not systematically decrease during CM relative to baseline. Additionally, 3 of the 9 participants did not complete the study. These findings suggest that the current arrangement did not improve barriers related to response requirements and behavioral costs. Significant methodological and practical limitations are discussed as well as their implications for future research and on global concerns of CM for smoking cessation