Financial incentives for smoking abstinence in patients diagnosed with pulmonary disease

Abstract

Aims: Chronic obstructive pulmonary disease (COPD) is a serious respiratory illness predominantly caused by cigarette smoking. While smoking cessation is identified as the single most effective intervention to slow the rate of disease progression and reduce COPD-related mortality, abstinence rates following smoking cessation among COPD patients are notoriously poor. We have an ongoing pilot study investigating the initial efficacy of an intensive, incentive-based intervention for promoting smoking abstinence in patients with COPD. Methods: Participants must report smoking>10 cigs/day, have a clinical diagnosis of COPD and have chronic airflow obstruction (post-bronchodilator FEV1/FVC<70%). Participants attend the clinic daily for 14 days and provide breath CO and urinary cotinine samples at each visit for monitoring of smoking status. Thus far, sevenparticipants (54yrsold, 29%male, 15cigs/day, 53%FEV1/FVC) have been randomized to one of two experimental groups: Contingent participants (n=4) earn voucher-based incentives ($362.50 max) contingent upon biochemically verified smoking abstinence and Noncontingent participants (n=3) receive vouchers independent of smoking status. Results: While abstinence is generally high for both groups, preliminary analyses show a trend toward greater biochemically verified smoking abstinence among Contingent vs. Noncontingent participants (68% vs. 50% negative samples, respectively; p= .11). By June 2013 wewill have full data from the completed pilot study (n=20), including primary outcomes of biochemically verified smoking abstinence as well as measures of nicotine withdrawal, craving and pulmonary functioning. Conclusions: Overall, this pilot study is positioned to provide thefirst demonstration that smokers diagnosedwithCOPDcan successfully quit smoking and inform efforts to develop an effective, longer-term smoking cessation intervention for this challenging and costly population of smokers. Financial support: Supported in part by T32 DA007242.