Motive8: Online contingency management for smoking cessation

Evaluations

• Effects of an Internet-based voucher reinforcement program for smoking abstinence: A feasibility study.

  Dallery J, Glenn IM. Journal of Applied Behavior Analysis. 2005. 38(3): 349-357. PMCID: PMC1239924.

  Summary: In this 4-week concurrent multiple baseline reversal study, 4 heavy smokers measured their breath carbon monoxide (CO) level two times per day. Participants reduced smoke intake (relative to baseline conditions); 75% achieved sustained periods of abstinence; abstinence reduction ranged from 32%-82%.

  Take Away: Results suggest that using a web-based voucher reinforcement method to promote abstinence is feasible.

• An Internet-based abstinence reinforcement treatment for cigarette smoking.

  Dallery J, Glenn IM, Raiff BR. Drug and Alcohol Dependence. 2007. 86(2-3):230-238. PMID:16930854

  Summary: In this 4-week concurrent multiple baseline reversal design study, 26 heavy smokers measured their breath carbon monoxide (CO) level twice daily. Significant decreases in CO were observed during treatment (relative to baseline conditions); many participants achieved sustained periods of abstinence. Ten participants showed abstinence induction without reversal.

  Take Away: Results indicate that a web-based voucher reinforcement program to promote abstinence is feasible and effective.

• A deposit contract method to deliver abstinence reinforcement for cigarette smoking.

  Dallery J, Meredith S, Glenn IM. Journal of Applied Behavior Analysis. 2008. 41(4):609-615. PMCID: PMC2606603.

  Summary: In this 24-day single-subject reversal design study, smokers measured their breath carbon monoxide (CO) level two times per day. For 7 of 8 participants, CO levels decreased (relative to baseline) during shaping and abstinence induction phases; participants showed evidence of sustained abstinence.

  Take Away: This study demonstrates that a deposit contract method of abstinence reinforcement is feasible.

• A web-based contingency management program with adolescent smokers.

  Reynolds B, Dallery J, Shroff P, Patak M, Leraas K. Journal of Applied Behavior Analysis. 2008. 41(4):597-601. PMCID: PMC2606598.

  Summary: In this 30-day reversal design study, four daily-smoking adolescents measured their breath carbon monoxide (CO) level three times per day. All participants reduced CO levels during abstinence, thinning and return-to-baseline conditions (relative to baseline).

  Take Away: This study provides preliminary evidence that a web-based CM program with adolescents is feasible and can promote positive changes in smoking behavior for adolescents.

• An Internet-based abstinence reinforcement smoking cessation intervention in rural smokers

  Stoops WW, Dallery J, Fields NM, Nuzzo PA, Schoenberg NE, Matin CA, Casey B, Wong CJ. Drug and Alcohol Dependence. 2009. 105(1-2):56-62. PMCID: PMC2743786.

  Summary: In this 6-week randomized, controlled, parallel group design study, participants were 68 smokers who reported residence in one of the 54 Appalachian counties in Kentucky. Participants received incentives contingent upon abstinence (Abstinence Contingent group-AC) or incentives independent of smoking status (Yoked Control group-YC). Breath carbon monoxide (CO) level was measured 2x per day. Participants assigned to AC group more likely to provide a negative sample (compared to Yoked Control group); AC group also more likely to achieve continuous abstinence.

  Take Away: Results show the feasibility and short-term efficacy of delivering reinforcement for smoking abstinence to rural populations over the Internet.

• Internet-based group contingency management to promote abstinence from cigarette smoking: A feasibility study.

  Meredith SE, Grabinski MJ, Dallery. Journal of Drug and Alcohol Dependence. 2011. 118(1):23-30. PMCID: PMC3144260.

  Summary: In this 14-day non-concurrent multiple baseline design study, 15 smokers submitted breath carbon monoxide (CO) samples twice daily. 57% of CO samples submitted during abstinence induction showed abstinence (compared to less than 1% during baseline); intervention was rated favorably by participants on acceptability questionnaire.

  Take Away: Results show that combining group contingencies and online peer support with internet based CM is a feasible strategy to promote abstinence.

• Investigating group contingencies to promote brief abstinence from cigarette smoking.

  Meredith SE, Dallery J. Experimental and Clinical Pharmacology. 2013. 21(2): 144-154. PMCID: PMC3657835.

  Summary: A randomized controlled trial was conducted to investigate the effects of adding a Group Support Forum to the Motiv8 program. Thirty-two smokers interested in quitting were enrolled and assigned to teams of three participants. Video recordings of breath carbon monoxide (CO) were submitted by all participants twice a day to test for cigarette use. Participants were randomized to three weeks of Motiv8 plus the Group Support Forum, or to Motiv8 only. In the Group Support Forum, participants were able to interact with teammates through posts. Participants in both conditions were exposed to three different contingency management programs for five day intervals. Therefore, participants could, 1) Receive vouchers for their own negative breath samples; 2) Receive vouchers when their whole team had negative breath samples; 3) Receive no vouchers. Each participant was exposed to all three contingency management conditions. At baseline, only 1% of CO samples were negative. During the three weeks participants used the Motiv8 program, 48% of samples were negative. The percentage of negative samples did not differ between the group receiving Motive8 plus the Group Support Forum and the group receiving only the Motiv8 program. Participants had significantly more negative CO samples when receiving vouchers either for their own negative samples or for their team negative samples.

  Take Away: The additional Group Support Forum does not appear to improve smoking cessation outcomes compared to the Motiv8 program alone. Receiving vouchers appears to be an important part of Motiv8 that contributes to reductions in smoking.