López-Núñez Carla, Secades-Villa Roberto, Peña-Suárez Elsa, Fernández-Artamendi Sergio, Weidberg Sara
a Department of Psychology , Private Technical University of Loja , Loja , Ecuador.
b Department of Psychology , University of Oviedo , Oviedo , Spain.
Subst Use Misuse. 2017 Jun 7;52(7):875-883. doi: 10.1080/10826084.2016.1264973. Epub 2017 Feb 22.
Contingency management (CM) has demonstrated its efficacy in treating many drug addictions, including nicotine. However, one of the most commonly perceived limitations with regard to its dissemination into community settings is whether this protocol could be equally effective for treating patients across different income levels.
This study aimed to examine whether individuals' income levels affect treatment success in a cognitive behavioral treatment (CBT) that included a voucher-based CM protocol for smoking cessation.
A total of 92 treatment-seeking smokers in a community setting were randomly assigned to a CBT group (N = 49) or to a CBT plus CM group (N = 43). The CM procedure included a voucher program through which smoking abstinence was reinforced on a schedule of escalating magnitude of reinforcement with a reset contingency. We analyzed the impact of self-reported monthly income, alone and in combination with treatment condition, on short-term (treatment retention) and long-term (self-reported number of days of continuous smoking abstinence at 6-month follow-up) results.
Income had no effect on treatment retention and continuous abstinence outcomes at 6-month follow-up in either treatment condition. Treatment modality emerged as the only significant predictor of treatment success.
Our findings suggest that treatment-seeking smokers from the general population respond equally well to CM regardless of their income levels. The results of this randomized controlled trial support the generalizability of this evidenced-based program into community settings.
应急管理（CM）已证明其在治疗包括尼古丁成瘾在内的多种药物成瘾方面的有效性。然而，关于其在社区环境中推广的最常见的局限性之一是该方案对不同收入水平的患者治疗效果是否相同。
本研究旨在探讨个体收入水平是否会影响一种认知行为疗法（CBT）的治疗成功率，该疗法包括基于代金券的戒烟应急管理方案。
在社区环境中，共有92名寻求治疗的吸烟者被随机分配到CBT组（N = 49）或CBT加CM组（N = 43）。CM程序包括一个代金券计划，通过该计划，根据强化幅度递增和重置应急的时间表来强化戒烟。我们分析了自我报告的月收入单独以及与治疗条件相结合对短期（治疗保留率）和长期（6个月随访时自我报告的连续戒烟天数）结果的影响。
在两种治疗条件下，收入对6个月随访时的治疗保留率和持续戒烟结果均无影响。治疗方式是治疗成功的唯一显著预测因素。
我们的研究结果表明，来自普通人群的寻求治疗的吸烟者，无论其收入水平如何，对CM的反应都同样良好。这项随机对照试验的结果支持了这一循证方案在社区环境中的可推广性。
