A Preoperative Contingency Management Intervention for Smoking Abstinence in Cancer Patients: A Preliminary Randomized Controlled Trial. Issue 6 (18th December 2020)

• Record Type: Journal Article
• Authors: Rojewski, Alana M; Fucito, Lisa M; Baker, Nathaniel L; Krishnan-Sarin, Suchitra; Carpenter, Matthew J; Bernstein, Steven L; Toll, Benjamin A
• Is Part Of: Nicotine & tobacco research. Volume 23:Issue 6(2021)
• Page Start: 1064
• Page End: 1067
• Publication Date: 2020-12-18
• Subjects: Nicotine -- Periodicals; Tobacco -- Research -- Periodicals; Tobacco habit -- Periodicals; Nicotine -- Periodicals; Tobacco -- Periodicals; Smoking -- Periodicals; 613.85
• DOI: 10.1093/ntr/ntaa266
• Languages: English
• ISSNs: 1462-2203

Abstract

Abstract: Introduction: The purpose of this study was to evaluate a pilot preoperative contingency management (CM) intervention for smoking abstinence. Aims and Methods: This multisite pilot study was conducted at two cancer center-based tobacco treatment programs. Participants who were smoking, diagnosed with or suspected to have any type of operable cancer, and had a surgical procedure scheduled in the next 10 days to 5 weeks ( N = 40) were randomized to receive standard care plus monitoring only (MO) or CM prior to surgery. All patients received breath carbon monoxide (CO) tests 3 times per week, nicotine patches, and counseling. The CM group also earned payments for self-reported smoking abstinence confirmed by CO breath test ≤6 ppm on an escalating schedule of reinforcement (with a reset if they smoked). Seven-day point prevalence abstinence rates on the day of surgery and at 3-month follow-up were compared between groups using repeated measures log-linear regression models utilizing generalized estimating equations. Participants lost to follow-up are assumed to have returned to smoking. Results: The sample was 50% female and 75% White. In covariate adjusted models, patients in the CM group had a greater probability of reported abstinence. On the day of surgery (end of treatment), 52% of CM patients were abstinent compared with 16% of patients in MO (risk ratio = 3.2 [1.1–9.3]; p = .03). At the 3-month follow-up, 43% of CM patients were abstinent compared with 5% in MO (risk ratio = 8.4 [1.5–48.3]; p = .02). Conclusions: Providing monetary incentives contingent on abstinence prior to cancer surgery may produce significant improvements in smoking abstinence rates relative to breath CO MO. Implications: In this pilot preoperative CM intervention for smoking abstinence, patients receiving a CM intervention prior to cancer surgery had a greater probability of smoking abstinence at the end of treatment compared with a breath MO group (52% vs. 16%, respectively). Thus, providing monetary incentives contingent on abstinence may produce significant improvements in smoking abstinence rates prior to cancer surgery relative to breath CO monitoring.