An Internet-based abstinence reinforcement smoking cessation intervention in rural smokers

William W. Stoops, Jesse Dallery, Nell M. Fields, Paul A. Nuzzo, Nancy E. Schoenberg, Catherine A. Martin, Baretta Casey, Conrad J. Wong

Research output: Contribution to journalArticle


The implementation of cigarette smoking abstinence reinforcement programs may be hindered by the time intensive burden placed on patients and treatment providers. The use of remote monitoring and reinforcement of smoking abstinence may enhance the accessibility and acceptability of this intervention, particularly in rural areas where transportation can be unreliable and treatment providers distant. This study determined the effectiveness of an Internet-based abstinence reinforcement intervention in initiating and maintaining smoking abstinence in rural smokers. Sixty-eight smokers were enrolled to evaluate the efficacy of an Internet-based smoking cessation program. During the 6-week intervention period, all participants were asked to record 2 videos of breath carbon monoxide (CO) samples daily. Participants also typed the value of their CO readings into web-based software that provided feedback and reinforcement based on their smoking status. Participants (n = 35) in the Abstinence Contingent (AC) group received monetary incentives contingent on recent smoking abstinence (i.e., CO of 4 parts per million or below). Participants (n = 33) in the Yoked Control (YC) group received monetary incentives independent of smoking status. Participants in the AC group were significantly more likely than the YC group to post negative CO samples on the study website (OR = 4.56; 95% CI = 2.18-9.52). Participants assigned to AC were also significantly more likely to achieve some level of continuous abstinence over the 6-week intervention compared to those assigned to YC. These results demonstrate the feasibility and short-term efficacy of delivering reinforcement for smoking abstinence over the Internet to rural populations.

Original languageEnglish (US)
Pages (from-to)56-62
Number of pages7
JournalDrug and alcohol dependence
Issue number1-2
StatePublished - Nov 1 2009


  • Abstinence reinforcement
  • Cigarettes
  • Randomized controlled trial
  • Rural
  • Smoking cessation
  • Tobacco

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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  • Cite this

    Stoops, W. W., Dallery, J., Fields, N. M., Nuzzo, P. A., Schoenberg, N. E., Martin, C. A., Casey, B., & Wong, C. J. (2009). An Internet-based abstinence reinforcement smoking cessation intervention in rural smokers. Drug and alcohol dependence, 105(1-2), 56-62.