Smoking Cessation in Recovery: Comparing 2 Different Cognitive Behavioral Treatments

Abstract

Objectives The purpose of this pilot demonstration study was to evaluate the feasibility and effectiveness of adding a contingency management (CM) component to the standard cognitive-behavioral smoking cessation treatment offered to veterans in a residential substance-abuse treatment program. Specifically, we assessed the impact of CM on (1) engagement in smoking cessation treatment, (2) retention in smoking cessation treatment, and (3) abstinence from smoking. Methods Participants were 65 male veterans in inpatient treatment for a primary substance use disorder who expressed interest in quitting smoking. Participants were enrolled in either the standard or CM smoking cessation treatment program. All participants were offered 4 sessions of cognitive-behavioral group counseling; participants in the CM program also had the opportunity to earn cash vouchers for session attendance and abstinence from smoking. Results The CM treatment program showed superior treatment engagement and retention rates. Survival analysis showed that 58% of participants receiving the CM treatment were smoke-free on quit day, versus only 17% of participants in standard care. In addition, the end of treatment continuous abstinence rate was significantly higher in the CM condition compared with standard care (21% vs. 0%). Conclusions These preliminary results suggest that contingency management approaches may be useful for maximizing participation in smoking cessation treatment and improving treatment outcomes among recovering substance users.