Contingency Management in the 21st Century: Technological Innovations to Promote Smoking Cessation

Abstract

Information technology represents an excellent medium to deliver contingencies of reinforcement to change behavior. Recently, we have linked the Internet with a science-based, behavioral treatment for cigarette smoking: abstinence reinforcement therapy. Under abstinence reinforcement interventions, incentives are provided for objective evidence of abstinence. Several studies suggest that the intervention is effective in initiating abstinence. The intervention addresses limitations (access, cost, sustainability, and dissemination potential) inherent in traditional abstinence reinforcement delivery models. It can also be applied to vulnerable, at-risk populations, and to other behavior to promote health. Information technologies offer unprecedented and rapidly expanding opportunities to facilitate behavior change.

Keywords :

• cigarette smoking
• abstinence reinforcement
• Internet
• contingency management
• carbon monoxide

THE AUTHORS

Jesse Dallery, PhD, is a Principal Investigator with the Center for Technology and Health at the National Development and Research Institutes in New York City. He is also an Associate Professor in the Department of Psychology at the University of Florida, and a Licensed Psychologist in the state of Florida. Dr. Dallery received his PhD in Clinical Psychology at Emory University in 1999, and completed a postdoctoral fellowship at the Johns Hopkins University School of Medicine in Behavioral Pharmacology. Dr. Dallery's research involves translational research on nicotine and smoking in animal and human laboratories. His work also focuses on novel applications of Internet-based behavioral interventions for cigarette smoking. He has published over 30 articles in peer-reviewed journals, and he has received grants from the National Institutes of Health and the National Science Foundation. He has conducted several studies suggesting that a novel, science-based intervention can promote smoking cessation. The treatment employs breath-based measures of smoking status, which also allows objective verification of treatment effects. In collaboration with colleagues, he is involved in extending the application to high-risk groups such as adolescents, pregnant women, and rural smokers. The intervention eliminates distance as a barrier, which should allow widespread dissemination of an effective behavioral intervention. The results also encourage the application of Internet-based technology to other health-related behavior. Currently, Dr. Dallery is conducting a randomized trial investigating the short- and long-term efficacy of the Internet-based treatment for cigarette smoking.

Bethany R. Raiff, PhD, is a Research Assistant Scientist in the Department of Psychology at the University of Florida. Dr. Raiff received her PhD in Psychology at the University of Florida in 2008 and is currently the Project Director for a randomized clinical trial testing the short- and long-term efficacy of an Internet-based abstinence reinforcement intervention with smokers. Dr. Raiff's research involves studying how drugs of abuse affect behavior, and improving methods to assess and treat drug abuse and other problem behavior. Thus far, her research has focused on the behavioral effects of nicotine, in both animal and human laboratories, and in investigating novel behavioral treatments for smoking cessation. She has also recently begun exploring novel interventions to improve medical regimen adherence to adolescent's diagnosed with Type 1 diabetes. Dr. Raiff has four first-authored publications and she is co-author of five articles. She is the recipient of a National Research Service Award from NIH, and she is a Co-Investigator on an NIH-funded grant. With nonhumans, Dr. Raiff has explored whether and to what extent nicotine increases the incentive value of certain non-pharmacological stimuli, such as food, visual stimuli, and conditioned reinforcers. These effects may help us understand a number of important features of smoking acquisition, maintenance, and relapse. On the other end of the spectrum, Dr. Raiff is refining and testing an Internet-based abstinence-reinforcement treatment for cigarette smoking, in collaboration with Dr. Dallery, and has recently extended the treatment to diabetes management.