Louisiana State University, Department of Psychology, Baton Rouge, LA, USA.
University of Oklahoma Health Sciences Center, Department of Family and Preventive Medicine, Oklahoma City, OK, USA; Stephenson Cancer Center, Oklahoma Tobacco Research Center, Oklahoma City, OK, USA.
Addict Behav. 2018 Sep;84:99-105. doi: 10.1016/j.addbeh.2018.03.018. Epub 2018 Mar 20.
Little is known about the mechanisms linking contingency management (CM) treatment with smoking cessation, and recent research suggests that the CM approach is associated with better smoking cessation outcomes among females than males. The current study investigated self-efficacy as a potential mechanism through which CM treatment influences smoking cessation, and explored whether these relationships differed by sex.
Participants (N = 139) were primarily Black (63.3%) and female (57.6%) adults enrolled in a safety-net hospital smoking cessation program. Participants received usual care (UC), which included pharmacotherapy and counseling sessions (n = 66) or a CM intervention (UC + 4 weeks of small, abstinence contingent financial incentives; n = 73). Self-efficacy for quitting was measured on the day after quitting with the Self-Efficacy Scale/Confidence (SESC) questionnaire. Mediation analyses were conducted to evaluate the indirect effects of treatment group on biochemically-verified abstinence (4-weeks post-quit) via self-efficacy, and moderated mediation analyses were conducted to evaluate the moderating role of sex.
Self-efficacy was not found to mediate the relations between CM treatment and smoking cessation in the overall sample. However, analyses indicated a significant moderating effect of sex on the indirect effect of treatment group on smoking cessation through self-efficacy (each of the 3 SESC subscales). Specifically, there was a stronger association between CM and greater self-efficacy among females than males.
Findings suggest that CM treatment had a differing impact on self-efficacy among males and females, which in turn influenced the likelihood of smoking cessation.
关于将权变管理（CM）治疗与戒烟联系起来的机制知之甚少，最近的研究表明，CM 方法与女性戒烟效果优于男性。本研究调查了自我效能感作为 CM 治疗影响戒烟的潜在机制，并探讨了这些关系是否因性别而异。
参与者（N=139）主要为黑种人（63.3%）和女性（57.6%），他们参加了一家医疗服务提供机构的戒烟项目。参与者接受常规护理（UC），包括药物治疗和咨询课程（n=66）或 CM 干预（UC+4 周的小剂量、与 abstinence 相关的经济奖励；n=73）。戒烟后第二天通过自我效能量表/信心（SESC）问卷测量自我效能感。进行中介分析，以评估治疗组通过自我效能感对生物验证戒烟（戒烟后 4 周）的间接效应，进行调节中介分析，以评估性别的调节作用。
在整个样本中，自我效能感并没有介导 CM 治疗与戒烟之间的关系。然而，分析表明，性别对治疗组通过自我效能感对戒烟的间接效应有显著的调节作用（SESC 的每个子量表）。具体来说，CM 与女性自我效能感之间的关联强于男性。
研究结果表明，CM 治疗对男性和女性的自我效能感有不同的影响，进而影响戒烟的可能性。
