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      Web-Based Contingency Management for Adolescent Tobacco Smokers: A Clinical Trial

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          Abstract

          Introduction

          Adolescence is a critical time when the majority of tobacco users initiate smoking. Contingency management for adolescent smoking cessation has shown promise in previous studies, but efficacy following removal of contingencies is not well understood. This study examined a remote form of contingency management among non-treatment-seeking adolescent smokers.

          Methods

          Participants ( N = 127) submitted breath carbon monoxide (CO) three times daily throughout a 42-day program. For this randomized trial, participants in the active condition ( n = 63) were reinforced for providing CO measurements on schedule and below a set criterion, whereas those in the control condition ( n = 64) were reinforced for providing CO measurements on schedule. Self-reported smoking and urinary cotinine levels were collected at several timepoints.

          Results

          Active condition showed greater within-group reductions in CO levels relative to control condition, but not at 3- or 6-month follow-up. Active condition reported significantly less smoking during treatment compared to control condition, but not at follow-up. There were no significant differences for urinary cotinine. Overall treatment adherence was low, with only 37% and 51% of possible CO samples being submitted among active and control, respectively. Poor treatment adherence may explain the disparity between CO and cotinine results, and poor follow-up treatment efficacy.

          Conclusions

          This study replicates feasibility of a remote form of contingency management for adolescent smoking. CO results suggest active condition reduced smoking within group, but treatment adherence and posttreatment efficacy was poor. Future research should focus on increasing adherence for this type of program among adolescent smokers.

          Implications

          This study demonstrates feasibility of a remote form of contingency management therapy for smoking cessation among adolescents, while providing posttreatment efficacy data. Within-group efficacy of this form of treatment is suggested, but treatment adherence and follow-up efficacy were poor. This study underscores the need for further development of contingency management therapy for adolescent smoking cessation, which emphasizes better treatment adherence and posttreatment efficacy.

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          Author and article information

          Journal
          Nicotine Tob Res
          Nicotine Tob. Res
          nictob
          Nicotine & Tobacco Research
          Oxford University Press (US )
          1462-2203
          1469-994X
          March 2020
          18 November 2018
          18 November 2019
          : 22
          : 3
          : 332-338
          Affiliations
          [1 ] Center for Tobacco Research and Education, University of California, San Francisco , San Francisco, CA
          [2 ] Markey Cancer Center, University of Kentucky , Lexington, KY
          [3 ] Markey Cancer Center and Department of Biostatistics, University of Kentucky , Lexington, KY
          [4 ] Department of Psychology, University of Florida , Gainesville, FL
          [5 ] Department of Psychology, Texas A&M University , College Station, TX
          [6 ] Department of Behavioral Science, University of Kentucky , Lexington, KY
          Author notes
          Corresponding Author: Brady Reynolds, PhD, Department of Behavioral Science, University of Kentucky, 105 Medical Behavioral Science Building, Lexington, KY 40536, USA. Telephone: 859-323-1457; E-mail: brady.reynolds@ 123456uky.edu
          Article
          PMC7297090 PMC7297090 7297090 nty243
          10.1093/ntr/nty243
          7297090
          30452705
          6c6f69e0-fbe7-4b0d-b001-bea6341c15a1
          © The Author(s) 2018. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

          This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model ( https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

          History
          : 23 March 2018
          : 09 November 2018
          : 07 November 2018
          Page count
          Pages: 7
          Funding
          Funded by: National Institutes of Health, DOI 10.13039/100000002;
          Funded by: National Institute on Drug Abuse, DOI 10.13039/100000026;
          Award ID: DA023476-01A2
          Funded by: Markey Cancer Center, University of Kentucky, DOI 10.13039/100015087;
          Award ID: P30CA177558
          Categories
          Original Investigations
          AcademicSubjects/MED00010
          AcademicSubjects/SOC02541

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