|5R01CA251451-03 Interpret this number
|University Of Oklahoma Hlth Sciences Ctr
|Mobile Contingency Management for Smoking Cessation Among Socioeconomically Disadvantaged Adults
Although smoking prevalence has declined to 13.7% among U.S. adults, smoking rates are much higher
among socioeconomically disadvantaged adults. Lung cancer, which is primarily caused by cigarette smoking,
is the leading cause of cancer death in the U.S. Lung cancer mortality is far greater among those of lower
socioeconomic status (SES) than their higher SES counterparts. Contingency management (CM), the tangible
reinforcement of abstinence and other desired outcomes, is an effective approach to promoting smoking
cessation in a variety of populations. The preliminary work of the investigators has indicated that offering small
escalating financial incentives for smoking abstinence dramatically increases cessation rates among
socioeconomically disadvantaged adults when incentives are included as an adjunct to clinic-based treatment.
However, innovative approaches are needed for those who are unable or unwilling to attend office visits.
Smartphone ownership is rapidly growing, even among low-income adults, and may offer a means of reaching
and increasing treatment access among socioeconomically disadvantaged adults. The purpose of the
proposed project is to evaluate an automated mobile phone-based CM approach that will allow
socioeconomically disadvantaged individuals to remotely benefit from financial incentives for smoking
cessation. The investigators have previously combined technologies including 1) portable carbon monoxide
monitors that connect with mobile phones to remotely verify smoking abstinence, 2) facial recognition software
to confirm participant identity during breath sample submissions, and 3) remote delivery of incentives
automatically triggered by biochemical confirmation of self-reported abstinence. This automated CM approach
will be evaluated in a randomized controlled trial that includes 532 socioeconomically disadvantaged males
and females seeking smoking cessation treatment. Participants will be randomly assigned to either telephone
counseling and nicotine replacement therapy (standard care [SC]) or SC plus a mobile financial incentives
intervention (CM) for biochemically-confirmed abstinence. Participants will be followed for 26 weeks after a
scheduled quit attempt. Biochemically-verified 7-day point prevalence abstinence at 26 weeks post-quit will be
the primary outcome variable. Cost-effectiveness will be evaluated to inform policy-related decisions. Potential
mobile CM treatment mechanisms, including self-efficacy, motivation, and treatment engagement, will be
explored to optimize future versions of the intervention. Automated mobile CM offers a low-cost approach to
smoking cessation that may be used in combination with existing telephone counseling and pharmacological
interventions. If effective, this approach represents a critical step towards the widespread dissemination of CM
treatment for smoking to practical settings (e.g. state quit lines, healthcare systems), with the goal of reducing
tobacco-related disease and disparities.
Review of strategies to investigate low sample return rates in remote tobacco trials: A call to action for more user-centered design research.
, Thrul J.
, DeVito A.
, Kendzor D.E.
, Sabo P.
, Khafif T.C.
Addiction neuroscience, 2023 Sep; 7, .
Mobile contingency management for smoking cessation among socioeconomically disadvantaged adults: Protocol for a randomized trial.
, Businelle M.S.
, Vidrine D.J.
, Frank-Pearce S.G.
, Shih Y.T.
, Dallery J.
, Alexander A.C.
, Boozary L.K.
, Waring J.J.C.
, Ehlke S.J.
Contemporary clinical trials, 2022 Mar; 114, p. 106701.