Learning Objectives: Describe the effects of an intense behavioral smoking cessation program in a residential treatment center
Abstract:
Problem/Objective: Assesses the efficacy of an intensive smoking cessation treatment with women (N=20) living with their children in a residential substance abuse treatment facility.
Methods: The study uses an A-B-A individual reversal design, in which a 1-week baseline is followed by 4 weeks of treatment, and 2 weeks of follow-up. The intervention consists of exposure to an educational video, advice to quit, group review of a smoking cessation workbook, 4 weekly individual counseling sessions, feedback on breath carbon monoxide (CO) concentration 3 times every weekday, feedback on weekend smoking from Monday morning urine cotinine (COT), and 4-week exposure to an escalating schedule of voucher-based reinforcement of abstinence from smoking. During the abstinence reinforcement intervention, participants receive vouchers of escalating value ($3.00-$10.00) for CO-negative breath samples (<=7 ppm). Positive breath or urine samples reset the voucher value to zero.
Results: To date 10 participants have completed the study, earning $472.75 on the average. In this preliminary data analysis (N=10), repeated measures ANOVA of the mean number of CO and COT-negative tests by treatment phase, indicated significant differences between treatment phases. Post-hoc analysis revealed more CO- and COT-negative tests during the intervention (41.8 %) than during baseline (18.3 %) and follow-up (18.7 %; both p< 0.05).
Conclusions: These preliminary results suggest that intensive cognitive-behavioral interventions are efficacious in motivating cigarette smoking cessation in this at-risk population, and that more prolonged interventions may be necessary to sustain abstinence once the reinforcement program is removed.
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