Contingency Management for Smoking Cessation

Overseen By Maddie Foster

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Medical University of South Carolina

Must be taking: Nicotine patch

Disqualifiers: Unstable psychiatric, Non-English, Pregnant, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 2 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

Duration: 6 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a new method to help people quit smoking, focusing on those with cancer or suspected cancer who are planning surgery. Half of the participants will receive a novel smoking cessation treatment called Contingency Management (also known as Motivational Incentives or the Prize Method), while all participants will receive standard support, such as counseling and nicotine patches. The researchers aim to determine if this new approach helps more people stop smoking compared to usual methods. Individuals who smoke at least one tobacco product daily and have a cancer diagnosis or suspicion may be suitable for this trial. As an unphased trial, this study provides a unique opportunity to contribute to innovative research that could enhance smoking cessation methods for cancer patients.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that Contingency Management is safe for smoking cessation?

Studies have shown that financial rewards, such as money or vouchers, can help people quit smoking and are generally well-received. Research indicates that these rewards effectively encourage smoking cessation and maintain smoke-free status without major side effects. Previous findings suggest that offering these incentives does not typically lead to harmful effects but instead helps maintain motivation to quit smoking. This method has succeeded in different settings and among various groups, suggesting it is a safe and promising way to support smoking cessation. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Contingency Management is unique because it uses a behavioral approach to encourage smoking cessation by offering incentives for meeting specific goals, like staying smoke-free. Unlike standard treatments that often rely on medication or counseling alone, this method directly rewards individuals for making positive changes, which can be a powerful motivator. Researchers are excited about this approach because it leverages the natural human response to rewards, potentially making it more effective for some people than traditional methods.

What evidence suggests that this trial's treatments could be effective for smoking cessation?

This trial will compare Contingency Management, which uses financial rewards to encourage quitting, with Standard Care for smoking cessation. Studies have shown that reward-based methods can significantly reduce smoking compared to standard care. However, some studies found that while these methods work well in the short term, the benefits might not last over time. Overall, strong evidence supports using incentives to quit smoking, and it is considered a promising strategy for helping people quit. ^{1 2 6 7 8}

Who Is on the Research Team?

Benjamin Toll, PhD

Principal Investigator

Medical University of South Carolina

Are You a Good Fit for This Trial?

This trial is for adult smokers diagnosed with or suspected to have operable cancer, who are about to undergo surgery. Participants must smoke at least one cigarette daily and speak English. Those using alternative nicotine products, pregnant women, or individuals with unstable psychiatric/medical conditions cannot join.

Inclusion Criteria

I have been diagnosed with or suspected to have a type of cancer that can be operated on.

You smoke at least one cigarette every day.

Exclusion Criteria

You use electronic cigarettes, snus, or other similar products that deliver nicotine.

I do not have any severe mental health issues like thoughts of suicide, psychosis, or dementia.

You are pregnant.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive standard smoking cessation therapy including counseling and the nicotine patch. Half of the participants receive a novel smoking cessation treatment.

6 weeks

Follow-up

Participants are monitored for smoking abstinence through self-report, Carbon Monoxide Breath Monitoring, and Anabasine testing.

6 months

What Are the Treatments Tested in This Trial?

Interventions

• Contingency Management

Trial Overview The study tests a new smoking cessation treatment against standard care in cancer patients facing surgery. Half will receive the novel treatment plus counseling and nicotine patches; the other half will get only the standard therapy.

How Is the Trial Designed?

Group I: Contingency Management Experimental Treatment 1 Intervention

Group II: Standard Care Active Control 1 Intervention

Who Is Running the Clinical Trial?

Medical University of South Carolina

Lead Sponsor

Trials

994

Recruited

7,408,000+

National Cancer Institute (NCI)

Collaborator

Trials

14,080

Recruited

41,180,000+

Published Research Related to This Trial

In a study involving 74 cocaine-dependent methadone outpatients over 12 weeks, both voucher and prize-based contingency management (CM) interventions led to longer durations of abstinence compared to standard treatment.

The study found no significant differences in outcomes between the voucher and prize systems, indicating that both methods are effective in promoting abstinence during treatment, which is linked to better long-term recovery outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Randomized trial of contingent prizes versus vouchers in cocaine-using methadone patients. Petry, NM., Alessi, SM., Hanson, T., et al.[2021]

Incentive and contingency management strategies have shown effectiveness in modifying smoking behavior, particularly in controlled settings, suggesting they can be beneficial for smoking cessation efforts.

Quit-and-win programs, which use incentives to encourage quitting, attract many participants and have produced modest quit rates, although the quality of evaluations varies and more rigorous studies are needed to confirm their effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Incentives in smoking cessation: status of the field and implications for research and practice with pregnant smokers. Donatelle, R., Hudson, D., Dobie, S., et al.[2006]

A contingency management procedure that rewards participants with accumulating money for abstaining from smoking led to a significantly higher likelihood of achieving a 48-hour period of abstinence compared to a procedure that deducted money for smoking.

Participants who earned money for continued abstinence were also less likely to miss appointments, indicating better engagement and adherence to the treatment program.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The relative contribution of economic valence to contingency management efficacy: a pilot study. Roll, JM., Howard, JT.[2021]

In a study involving 146 participants from a smoking cessation program, those who received financial incentives for abstinence (contingency management) had significantly higher smoking abstinence rates compared to those who received usual care, with rates of 49.3% versus 25.4% at 4 weeks post-quit date.

The financial incentives, averaging $63.40 earned by participants, proved effective in encouraging abstinence, particularly among socioeconomically disadvantaged individuals, suggesting that such strategies could enhance smoking cessation efforts in similar populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Financial incentives for abstinence among socioeconomically disadvantaged individuals in smoking cessation treatment. Kendzor, DE., Businelle, MS., Poonawalla, IB., et al.[2022]

The Internet-based contingency management intervention led to a higher rate of negative breath carbon monoxide samples (66.7%) in the contingent group compared to the noncontingent group (25%), indicating that the incentive system effectively promoted smoking cessation during treatment.

Both groups showed a significant reduction in carbon monoxide levels (15.6 ppm), suggesting that elements like feedback and goal-setting contributed to reduced smoking, even though there were no significant differences in long-term abstinence rates at 3- and 6-month follow-ups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Internet-based contingency management to promote smoking cessation: a randomized controlled study. Dallery, J., Raiff, BR., Grabinski, MJ.[2022]

In a study involving 81 nicotine-dependent smokers, the addition of prize-based contingency management (CM) to standard care significantly reduced smoking during treatment compared to standard care alone.

However, these reductions in smoking did not persist after the treatment ended, indicating that while prize CM can be effective in the short term, it may not lead to long-term cessation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Prize contingency management for smoking cessation: a randomized trial. Ledgerwood, DM., Arfken, CL., Petry, NM., et al.[2022]

In a study involving 75 socioeconomically disadvantaged adults, those who placed greater importance on earning financial incentives for smoking cessation were significantly more likely to achieve continuous abstinence during the four-week intervention (OR = 3.95) and up to 12 weeks post-quit day (OR = 4.71).

The results indicate that an individual's perception of the importance of financial incentives can predict their success in quitting smoking, suggesting that tailoring incentive programs to enhance perceived value may improve outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Greater perceived importance of earning abstinence-contingent incentives is associated with smoking cessation among socioeconomically disadvantaged adults. Alexander, AC., Hébert, ET., Businelle, MS., et al.[2022]

Monetary incentives based on group performance significantly promoted brief abstinence from cigarette smoking, with 53% of participants submitting negative breath carbon monoxide samples when vouchers were contingent on team performance.

Both individual and team-based incentives were effective in increasing abstinence rates compared to a no-voucher condition, suggesting that interdependent contingencies can be a cost-effective strategy for smoking cessation programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Investigating group contingencies to promote brief abstinence from cigarette smoking. Meredith, SE., Dallery, J.[2023]

Internet-based deposit contracts for smoking cessation were effective in increasing the number of breath samples meeting the carbon monoxide criterion, with 47% success in Experiment 1 and 41.5% in Experiment 2, compared to virtually no success during baseline measurements.

Participants found the deposit contract interventions acceptable and feasible, indicating a positive reception that could support further research into their long-term effectiveness for smoking cessation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Internet-based self-tailored deposit contracts to promote smoking reduction and abstinence. Jarvis, BP., Dallery, J.[2018]

In a study involving 142 outpatients with cocaine or heroin dependence, both voucher and prize-based contingency management (CM) interventions led to longer treatment retention and greater durations of confirmed abstinence compared to standard treatment.

While there were no significant differences in abstinence rates at 6- and 9-month follow-ups, the duration of abstinence achieved during treatment was the strongest predictor of continued abstinence after treatment ended.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Vouchers versus prizes: contingency management treatment of substance abusers in community settings. Petry, NM., Alessi, SM., Marx, J., et al.[2016]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3411852/

The Use of Financial Incentives in Promoting Smoking ... We review research on the systematic use of financial incentives to promote abstinence from smoking. Incentive-based interventions, also known as contingency ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5020416/

Prize Contingency Management for Smoking Cessation Prize CM resulted in significant reductions in cigarette smoking relative to SC. These reductions were not apparent at follow-up. We found no meaningful ...

3. cochranelibrary.com cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004307.pub7/references

Incentives for smoking cessation - Notley, C - 2025 Effects of smoking cessation with voucher-based contingency management on birth outcomes. ... Increasing contingency management success in smoking cessation.

4. academic.oup.com academic.oup.com/ntr/article/27/8/1319/8023214

Financial Incentives for Substance Abstinence: A Systematic ... Financial incentives are likely to be effective for substance use cessation. The evidence for this outcome is highly certain due to the homogeneity of study ...

5. researchgate.net researchgate.net/publication/260091453_Reward-Based_Incentives_for_Smoking_Cessation_How_a_Carrot_Became_a_Stick

Reward-Based Incentives for Smoking Cessation How a ... Other studies have found peer and family support and the use of NRT to be predictors of smoking cessation [3,[29][30][31] [32] . Incentives for participation ...

6. researchgate.net researchgate.net/publication/291420033_Randomized_Trial_of_Four_Financial-Incentive_Programs_for_Smoking_Cessation

Randomized Trial of Four Financial-Incentive Programs for ... Studies to better refine this reversion curve could lead to improved contingency management-based methods for guiding smoking cessation therapy [49] . ...

7. tobaccocontrol.bmj.com tobaccocontrol.bmj.com/content/early/2025/04/22/tc-2024-059198

Financial incentives for smoking cessation among ... We systematically reviewed evidence addressing the barriers and facilitators to successful implementation of incentive-based smoking cessation interventions ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6635501/

Incentives for smoking cessation - PMC - PubMed Central - NIH Financial incentives, monetary or vouchers, are widely used in an attempt to precipitate, reinforce and sustain behaviour change, including smoking cessation.