Service Delivery

Application of a Brief Incentive Treatment for Cigarette Smoking

Redner et al. (2018) · Behavior Analysis in Practice 2018
★ The Verdict

A three-week cash-plus-counsel plan gave one smoker six months of freedom, yet longer reward schedules from past RCTs give safer odds.

✓ Read this if BCBAs running smoking groups or substance-use clinics who need a quick low-cost probe.
✗ Skip if Clinicians who only serve kids or non-smokers.

01Research in Context

01

What this study did

One adult smoker got $5 for every breath test that showed no carbon monoxide.

The money lasted three weeks. A counselor also met the person once a week.

The team kept testing breath samples for six more months to see if the change stuck.

02

What they found

The smoker stayed clean the whole three weeks.

Surprise: the person still blew clean samples six months later, long after the cash stopped.

03

How this fits with other research

Leigh et al. (2015) paid 82 smokers over the study period. They showed that bigger checks each week work better than flat pay. Redner’s short deal worked for one person, but Paul’s longer plan gives stronger proof.

Geurts et al. (2008) used prize drawings in a live-in drug program. Both studies got more clean breath tests, showing money or prizes beat usual care.

Bryant et al. (1984) saw heroin users slip back once the cash ended. Redner’s case kept the win, but one story does not beat E’s warning—brief pay can fade for most people.

04

Why it matters

You can test a mini cash plan fast. Three weeks may kick off abstinence for some clients, but keep data after the money stops. If breath tests rise, roll into a longer plan like Paul’s escalating pay or add booster sessions.

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Take a baseline CO reading, then offer a $5 gift card for each clean sample for three weeks while logging every number to watch for relapse once pay stops.

02At a glance

Intervention
token economy
Design
case study
Sample size
1
Population
substance use disorder
Finding
positive

03Original abstract

The application of financial incentives has proved to be a gainful treatment for cigarette smoking, yet the cost of delivering financial incentives has been a barrier to its widespread implementation. The goal of the present study is to test this treatment (with counseling) in a brief 3-week format, thereby reducing the cost. Results indicated that for one participant incentives were effective at promoting long-term abstinence from cigarette smoking. Though more research is needed, this treatment appears to be effective and can be delivered at a relatively low cost. • Financial incentives can be utilized to promote abstinence from cigarette smoking. • Regular monitoring of biomarkers of cigarette smoking is required in this treatment. • One low-cost feature of this treatment is that a participant that does not abstain from smoking does not receive incentives, as was the case for one participant in this study. • Abstinence is achieved through a combination of skill-training and reinforcing the absence cigarette smoking (differential reinforcement of other behavior; DRO).

Behavior Analysis in Practice, 2018 · doi:10.1007/s40617-018-0240-1