Contingency Management + Cognitive Behavioral Therapy for Quitting Vaping

Overseen By Thomas Liss, BS

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Yale University

Must not be taking: Psychoactive drugs

Disqualifiers: Substance use dependence, Psychosis, Major depression, Panic disorder, others

Compensation: Varies

Number of Visits: 5

Duration: 4 weeks

108 Participants Needed

Trial Summary

What is the purpose of this trial?

This trial aims to help teenagers who vape quit by using rewards and online counseling. The program targets teens aged 13-19 who want to stop vaping. It works by giving rewards for not vaping and providing counseling to change their behavior and thoughts about vaping.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, if you are using psychoactive drugs like anxiolytics or antidepressants, you must have been on them consistently for 2 months, and your condition should be stable and monitored by a doctor.

What data supports the effectiveness of this treatment for quitting vaping?

Research shows that contingency management (CM), a treatment that rewards people for not using substances, is effective for quitting smoking and other substance use. Studies have found that CM, especially when combined with cognitive-behavioral therapy (CBT), helps people stop smoking and stay abstinent, suggesting it could also help with quitting vaping. ^{1 2 3 4 5}

Is Contingency Management + Cognitive Behavioral Therapy safe for humans?

The studies on Contingency Management (CM) for smoking cessation, including those using internet-based and mobile phone delivery, have not reported any significant safety concerns, suggesting it is generally safe for human use. ^{1 2 6 7 8}

How does the Remote Contingency Management (CM) treatment for quitting vaping differ from other treatments?

Remote Contingency Management (CM) is unique because it uses rewards to encourage nicotine abstinence, which is not commonly used in traditional smoking cessation treatments. This approach is delivered remotely, making it more accessible and convenient compared to in-person therapies. ^{1 2 9 10 11}

Research Team

Suchitra Krishnan-Sarin, PhD

Principal Investigator

Yale University

Eligibility Criteria

This trial is for high school students aged 13-19 who regularly use e-cigarettes with nicotine and want to quit. They must be able to read and write, have no major mental health issues untreated, not use psychoactive drugs or antidepressants unless stable and monitored, not pregnant or lactating, and without substance dependence except mild cannabis use.

Inclusion Criteria

I use e-cigarettes regularly and want to quit.

Able to read and write

Does not meeting criteria for dependence on other psychoactive substances, psychosis, major depression or panic disorder based on psychological evaluation.

Exclusion Criteria

I do not have psychosis or a high risk of harming myself or others.

I've been on stable doses of my mental health meds for over 2 months.

Currently enrolled in, or planning to enroll in any other behavioral or pharmacological treatments for cessation of nicotine or vaping

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo a 4-week Remote Contingency Management intervention with weekly CBT sessions

4 weeks

4 weekly sessions (virtual)

Follow-up

Participants are monitored for safety and effectiveness after treatment with follow-up appointments

12 months

Follow-up at 1, 3, 6, and 12 months

Treatment Details

Interventions

• Control
• Remote Contingency Management (CM) for nicotine abstinence

Trial Overview The study tests a new program combining rewards (contingency management) with online video counseling (cognitive behavioral therapy) to help teenagers stop vaping. Participants will either receive this intervention or be in a control group that does not receive the treatment.

Participant Groups

Group I: Remote Contingency Management (CM) for nicotine abstinence Experimental Treatment 1 Intervention

Participants will be paid increasing amounts of payment for each negative saliva cotinine test.

Group II: Control Placebo Group 1 Intervention

Participants will be paid for providing saliva nicotine test, regardless of whether the test is positive or negative.

Who Is Running the Clinical Trial?

Yale University

Lead Sponsor

Trials

1,963

Recruited

3,046,000+

American Heart Association

Collaborator

Trials

352

Recruited

6,196,000+

Findings from Research

In a study of 94 smokers, an internet-based contingency management program that provided financial incentives for verified abstinence significantly increased short-term smoking cessation rates at 4 weeks (39.6% abstinence) compared to a control group (13.0% abstinence).

While the initial benefits of the incentive program diminished over time, with no significant differences at 3 and 6 months, the program was well-received, particularly for its ease of use and the financial rewards, indicating its potential as an effective tool for promoting smoking cessation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Nationwide access to an internet-based contingency management intervention to promote smoking cessation: a randomized controlled trial. Dallery, J., Raiff, BR., Kim, SJ., et al.[2022]

Contingency management (CM) significantly improved tobacco abstinence rates when added to cognitive-behavioral treatment (CBT) for smoking cessation in a study of 80 participants, indicating its effectiveness in the short term.

However, the benefits of CM diminished after treatment ended, and quitting smoking did not negatively impact abstinence from other substances, suggesting that smoking cessation does not jeopardize recovery from substance use disorder.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized controlled trial of contingency management for smoking cessation in substance use treatment patients. Secades-Villa, R., Aonso-Diego, G., González-Roz, A.[2022]

Remote delivery of contingency management (CM) for substance use treatment has been shown to improve outcomes such as abstinence and engagement in treatment, similar to in-person CM, based on a systematic review of 39 studies.

The majority of these studies (57.5%) were of strong quality, indicating that remote CM is not only feasible across various digital platforms but also effective in reducing barriers to treatment access for patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A systematic review of remotely delivered contingency management treatment for substance use. Coughlin, LN., Salino, S., Jennings, C., et al.[2023]

In a study of 92 treatment-seeking patients, combining contingency management (CM) with cognitive-behavioral treatment (CBT) significantly improved smoking cessation rates, with 95.3% achieving abstinence post-treatment compared to 59.2% in the CBT-only group.

The combination of CBT and CM also led to higher long-term abstinence rates, with 51.2% maintaining abstinence at six months, compared to 28.6% in the CBT group, demonstrating the effectiveness and feasibility of this approach in a community setting.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Contingency management for smoking cessation among treatment-seeking patients in a community setting. Secades-Villa, R., García-Rodríguez, O., López-Núñez, C., et al.[2022]

References

1. England pubmed.ncbi.nlm.nih.gov

Nationwide access to an internet-based contingency management intervention to promote smoking cessation: a randomized controlled trial. [2022]

2. Spain pubmed.ncbi.nlm.nih.gov

A randomized controlled trial of contingency management for smoking cessation in substance use treatment patients. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Pilot Cohorts for Development of Concurrent Mobile Treatment for Alcohol and Tobacco Use Disorders. [2022]

4. Ireland pubmed.ncbi.nlm.nih.gov

A pilot feasibility study of a behavioral intervention for nicotine vaping cessation among young adults delivered via telehealth. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

A systematic review of remotely delivered contingency management treatment for substance use. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

An open-label pilot study of an intervention using mobile phones to deliver contingency management of tobacco abstinence to high school students. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

A web-based contingency management program with adolescent smokers. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Technology-based contingency management and e-cigarettes during the initial weeks of a smoking quit attempt. [2020]

9. Ireland pubmed.ncbi.nlm.nih.gov

Contingency management for smoking cessation among treatment-seeking patients in a community setting. [2022]

10. United Arab Emirates pubmed.ncbi.nlm.nih.gov

Contingency management for smoking cessation: where do we go from here? [2019]

11. Spain pubmed.ncbi.nlm.nih.gov

Voucher-based contingency management and in-treatment behaviors in smoking cessation treatment. [2020]