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Drug Alcohol Depend. 2014 May 1;138:67-74. doi: 10.1016/j.drugalcdep.2014.02.007. Epub 2014 Feb 15.

The association between changes in alternative reinforcers and short-term smoking cessation.

Author information

1
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, United States. Electronic address: goelzp@mail.med.upenn.edu.
2
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, United States.
3
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lakeshore Drive, Chicago, IL 60611, United States.
4
Pulmonary, Allergy, & Critical Care Division, University of Pennsylvania Presbyterian Medical Center, 51 N. 39th Street, 1st Floor Rear, Philadelphia, PA 19104, United States.

Abstract

BACKGROUND:

While more than 50% of smokers make a serious quit attempt each year, less than 10% quit permanently. Evidence from studies of adolescent smoking and other substances of abuse suggest that alternative reinforcers, a construct of Behavioral Economic Theory, may contribute to the likelihood of smoking cessation in adults. This study examined the behavioral economics of smoking cessation within a smoking cessation clinical trial and evaluated how depressive symptoms and behavioral economic variables are associated with smoking cessation.

METHODS:

A sample of 469 smokers, enrolled in an effectiveness trial that provided counseling and 8 weeks of 21 mg nicotine patches, was analyzed. Alternative reinforcers (substitute and complementary reinforcers) and depressive symptoms were examined in relation to 7-day point prevalence abstinence, verified with breath carbon monoxide, 8 weeks after the quit date.

RESULTS:

Controlling for covariates associated with cessation (nicotine dependence, age of smoking initiation, patch adherence), participants who were abstinent at week 8 showed significantly higher substitute reinforcers at all time-points, compared to those who were smoking (p's<.05). Participants who were abstinent at week 8 showed lower complementary reinforcers and depressive symptoms at all time-points, compared to those who were smoking, but significant differences were confined to week 8 (p's<.01). There was no significant interaction between alternative reinforcers and depressive symptoms across the 8 weeks on week 8 abstinence.

CONCLUSIONS:

These results support continued examination of Behavioral Economic Theory in understanding adult smoking cessation in order to inform future treatments and guidelines.

KEYWORDS:

Alternative reinforcers; Behavioral economics; Depression; Smoking cessation

PMID:
24598122
PMCID:
PMC4030632
DOI:
10.1016/j.drugalcdep.2014.02.007
[Indexed for MEDLINE]
Free PMC Article

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