A Contingency-Management Intervention to Promote Initial Smoking Cessation Among Opioid-Maintained Patients

Kelly Dunn, Stacey C. Sigmon, Edward F. Reimann, Gary J. Badger, Sarah H. Heil, Stephen T. Higgins

Research output: Contribution to journalArticle

Abstract

Prevalence of cigarette smoking among opioid-maintained patients is more than threefold that of the general population and associated with increased morbidity and mortality. Relatively few studies have evaluated smoking interventions in this population. The purpose of the present study was to examine the efficacy of contingency management for promoting initial smoking abstinence. Forty methadone- or buprenorphine-maintained cigarette smokers were randomly assigned to a contingent (n = 20) or noncontingent (n = 20) experimental group and visited the clinic for 14 consecutive days. Contingent participants received vouchers based on breath carbon monoxide levels during Study Days 1 to 5 and urinary cotinine levels during Days 6 to 14. Voucher earnings began at $9.00 and increased by $1.50 with each subsequent negative sample for maximum possible of $362.50. Noncontingent participants earned vouchers independent of smoking status. Although not a primary focus, participants who were interested and medically eligible could also receive bupropion (Zyban). Contingent participants achieved significantly more initial smoking abstinence, as evidenced by a greater percentage of smoking-negative samples (55% vs. 17%) and longer duration of continuous abstinence (7.7 vs. 2.4 days) during the 2 week quit attempt than noncontingent participants, respectively. Bupropion did not significantly influence abstinence outcomes. Results from this randomized clinical trial support the efficacy of contingency management interventions in promoting initial smoking abstinence in this challenging population.

Original languageEnglish (US)
Pages (from-to)37-50
Number of pages14
JournalExperimental and Clinical Psychopharmacology
Volume18
Issue number1
DOIs
StatePublished - Feb 2010

Fingerprint

Smoking Cessation
Opioid Analgesics
Smoking
Bupropion
Population
Cotinine
Buprenorphine
Methadone
Carbon Monoxide
Tobacco Products
Randomized Controlled Trials
Morbidity
Mortality

Keywords

  • buprenorphine
  • bupropion
  • contingency management
  • methadone
  • smoking cessation

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Psychiatry and Mental health
  • Medicine(all)

Cite this

A Contingency-Management Intervention to Promote Initial Smoking Cessation Among Opioid-Maintained Patients. / Dunn, Kelly; Sigmon, Stacey C.; Reimann, Edward F.; Badger, Gary J.; Heil, Sarah H.; Higgins, Stephen T.

In: Experimental and Clinical Psychopharmacology, Vol. 18, No. 1, 02.2010, p. 37-50.

Research output: Contribution to journalArticle

Dunn, Kelly ; Sigmon, Stacey C. ; Reimann, Edward F. ; Badger, Gary J. ; Heil, Sarah H. ; Higgins, Stephen T. / A Contingency-Management Intervention to Promote Initial Smoking Cessation Among Opioid-Maintained Patients. In: Experimental and Clinical Psychopharmacology. 2010 ; Vol. 18, No. 1. pp. 37-50.
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