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

Abstract

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.

Smoking Reductions and Increased Self-Efficacy in a Randomized Controlled Trial of Smoking Abstinence–Contingent Incentives in Residential Substance Abuse Treatment Patients

“…Our expectations about the feasibility of twice-daily sessions exceeded observations. Individual and programmatic circumstances may restrict in-person monitoring, but technology can also monitor and reinforce smoking abstinence remotely (Alessi & Petry, 2013;ongoing clinical trial NCT01484717;Dallery, Glenn, & Raiff, 2007;Stoops et al, 2009).…”

A Mobile Game to Support Smoking Cessation: Prototype Assessment (Preprint)

“…Carbon monoxide (CO) is one method to biochemically verify abstinence; however, the half-life of CO is short (~3-6 hours), requiring at least twice daily check-ins to verify abstinence [20]. To address this barrier, Dallery and colleagues developed an efficacious CM intervention that is delivered over the Internet [11,17,21,22], in which participants are provided with a breath CO monitor, and remotely record and submit video clips of themselves providing their breath CO samples twice daily. More recently, mobile CM for smoking cessation (where participants use the camera on their smartphone to record and submit the video clips) has been shown to be feasible, acceptable, and show promise in promoting smoking abstinence [23][24][25].…”

Computer and mobile technology-based interventions for substance use disorders: An organizing framework

“…We also acknowledge that our organizing framework isn't intended to incorporate creative uses of technology to accomplish clinically relevant tasks that were once only possible face-to-face. For example, contingency management interventions have been developed in which abstinence is documented via video (e.g., Stoops et al, 2009). Other applications of technology to psychosocial and behavioral interventions we do not address are therapist training programs and programs that therapists can use to guide their live sessions with clients (see Cucciare, Weingardt, & Humphreys, 2009).…”