The Effects of Reduced Cigarette Smoking on Discounting Future Rewards: An Initial Evaluation

Abstract

To determine whether reduction of smoking via contingency management in dependent smokers would decrease the discounting of delayed reinforcers compared with smokers who did not reduce their smoking, moderate to heavy cigarette smokers were randomly assigned to one of two conditions: a contingency management condition and a control condition. In three phases (baseline discounting determination for hypothetical money and cigarettes, implementation of a contingency management or control condition, and postintervention discounting determination), the procedure to reinforce reduction in cigarette smoking produced CO decreases in all subjects exposed to that procedure. Discounting decreased significantly for both cigarettes and money among the group for whom smoking reductions were reinforced, whereas the control group showed no significant change for either commodity. Reductions in smoking can lead to reductions in discounting, and increased discounting in current smokers may be a reversible effect of nicotine dependence.Delay discounting refers to the intuitive conception that the influence of a delayed reward decreases as a function of that delay (Logue, 1988). For instance, the subjective value (and thereby the influence) of some monetary reward available immediately is greater than the same reward available after 1 month, which is still greater than the same reward available after 1 year. Studies of delay discounting typically attempt to determine the present subjective value of rewards at numerous delays, resulting in some index of the rate of discounting.Rate of discounting is a popular metric in studies of drug dependence, consistently showing that drug-dependent populations discount delayed rewards more than nondependent controls do (see Bickel & Marsch, 2001). Among the many drug-dependent populations who have undergone delay discounting measures are cigarette smokers. Studies by Baker, Johnson,

Self-Control and Impulsiveness in Nondieting Adult Human Females: Effects of Visual Food Cues and Food Deprivation

“…Furthermore, it should be noted that in the nonhuman literature, many inconsistencies in deprivation of food effects have been demonstrated (Bradshaw & Szabadi, 1992;eisenberger & Masterson, 1987;eisenberger et al, 1982;Logue & Peña-Correal, 1985), and perhaps we are seeing that in these human experiments as well. As evidence of this inconsistency in the human literature, experiments depriving adults of reinforcers other than food-for example, having smokers abstain from cigarettes or having opiod-dependent people abstain from heroin-have shown mixed results: Abstinence has been reported to be associated with greater self-control (Yi et al, 2008) and less self-control (Giordano et al, 2002;Mitchell, 2004). Additional research could examine the differences in the effects of deprivation on dieters and nondieters and could also examine the effects of brief and longer term deprivation.…”

Resident Decision Making: Opioids in the Outpatient Setting

“…Programs, including preclinical seminars, clinical rotations, and focused curricula [17][18][19][20][21][22][23][24][25] educate medical students and residents in countering temporal discounting of the long-term benefits of deferring opioid analgesia and the long-term risks of prescribing. It might be useful to intervene and include education for nurses and patients as well.…”

“…For example, contingency management has proven effective in several populations of substance abusers. [18][19][20] Contingency management entails the repeated (often positive) reinforcement of appropriate behaviors, abstinence in the case of substance abusers, and appropriate pain management in the case of residents. In the simplest application of this technique, medical educators should continue to encourage and applaud residents for managing their patients in CNMP with nonopioid regimens or referring them to subspecialty providers when able.…”

“…[18][19][20][21][22][23][24][25] These methods are summarized in the Future research is needed to determine whether improved understanding of the principles of temporal discounting would be of benefit to resident decision making and to the patients. Advice from experts and peers 25 has been shown to diminish temporal discounting in other settings, as has preparation for decisions ahead of time (termed ''precommitment''), rather than in the ''heat of the moment.''…”

What are we doing when we translate from quantitative models?

“…Thus, pretreatment impulsiveness is best characterized in terms of a complete discounting function in which the appeal of a given consequence is known for many levels of delay (e.g., Figure 1, Panel B, lower function). If it is difficult in words to say exactly how fast value decreases as a function of delay in this single instance, then the problem is magnified substantially when we compare two discounting functions (Panel B), as would be the case when evaluating the intervention's effectiveness (for examples of this approach, see Bickel & Odum, 1999;Yi et al, 2008).…”