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Chivers, Laura Lynn

Psychology

2006

MA

The goal of the present study was to use contingency management to bring smoking under experimental control and to examine the influence of duration of abstinence and programmed smoking lapses on measures associated with relapse risk. Participants were 58 adult smokers not currently trying to quit long-term who were randomly assigned to receive abstinence-contingent payments for either 1 day (1C; n=l5) or 14 consecutive days (14C; n=43). Among those receiving abstinent-contingent payments for 14 days, participants were randomized to receive programmed lapses of 0, 1 or 8 puffs on a cigarette on five evenings during the 14-day study period. Participants in the 1 C condition also participated in programmed smoking lapses and were all assigned to receive 0 puffs. Smoking status was assessed 3x/day throughout the study, with abstinence operationalized as breath CO <̲ 4 ppm. Participants completed questionnaires each evening of the study assessing nicotine withdrawal, desire to smoke, and other measures. On the final evening of the study, participants completed a 3-hr smoking-preference session wherein they made a maximum of 20 exclusive choices between receiving two puffs on a cigarette or earning money ($.25/choice). There was no evidence that programmed smoking lapses affected any of the dependent measures. Contingency management was effective at manipulating abstinence levels. Breath COs were significantly lower in the 14C than in the 1C condition across Days 1-13, but did not differ on Day 14 when both groups received abstinence-contingent payments. Participants in the 14C condition reported that abstaining became progressively easier during Days 1-13, while there was no such change in ratings by those in the 1C condition. That difference in participant-rated ease of abstaining remained discernible on Day 14. Nicotine withdrawal symptomatology generally increased and then decreased over Days 1-13 in the 14C condition while remaining unchanged in the 1C condition. No significant differences between conditions were noted in the 3-hr smoking-preference session, although a non-significant trend toward a lower preference for smoking in the 14C condition was observed when the comparison was limited to those who abstained continuously during their contingent periods. Overall, these results provide further systematic observations regarding changes that occur during a period of initial abstinence and offer additional but mixed support for the idea that a period of sustained abstinence directly reduces relapse risk.