Incentivizing university students to quit smoking: a randomized controlled trial of a contingency management intervention in a developing country

• Published in: The American journal of drug and alcohol abuse Vol. 46; no. 1; pp. 109 - 119
• Main Authors: Hofmeyr, Andre, Kincaid, Harold, Rusch, Olivia
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 02.01.2020; Taylor & Francis Ltd
• Subjects: Abstinence; Behavior modification; Behavior Therapy - economics; Behavior Therapy - methods; cessation; Cigarette Smoking - therapy; Cigarettes; Clinical trials; College students; Colleges & universities; contingency management; Developing Countries; developing country; Efficacy; Female; Health services utilization; Help seeking behavior; Humans; Incentives; Intervention; LDCs; Male; Motivation; Participation; Recruitment; Smoking; Smoking Cessation; South Africa - epidemiology; Students; Tobacco; treatment; Universities; University students; Young Adult; South Africa; treatment; Tobacco; incentives; developing country; cessation; smoking; contingency management
• ISSN: 0095-2990; 1097-9891; 1097-9891
• DOI: 10.1080/00952990.2019.1622130

Background: Contingency management (CM) is an empirically supported behavioral treatment for tobacco use, but its efficacy with university student smokers in a developing country is unknown. Objectives: We evaluate a randomized controlled trial of a CM smoking cessation program conducted on a sample of treatment-seeking student smokers at the University of Cape Town. Methods: The study included a recruitment period, a 6-week intervention period, and a 6-month follow-up period. Subjects in the control group (information and monitoring; n = 47, 76% male) were given information to help them quit smoking and had their quit attempt monitored, receiving R50 ($8) at each assessment. Subjects in the treatment group (information and monitoring, plus CM; n = 40, 80% male) could additionally earn R150 ($24) in abstinence-contingent incentives at each assessment. Outcome variables: 7-day point-prevalence abstinence at 6 months and at the end of the intervention period, and a repeated measure of smoking intensity of non-abstinent subjects. Results: CM had no long-term effect on abstinence at 6 months but had a marked and statistically significant effect on the likelihood of abstinence by the end of the intervention period (p < .001). In addition, while CM did not affect smoking intensity, participation in the program decreased the average number of cigarettes smoked per day by non-abstainers (p < .001). Conclusions: The CM program was efficacious in promoting abstinence amongst treatment-seeking university students in a developing country but only while incentives were in place. Future research should focus on promoting continuous abstinence with this target sample.