Center for Tobacco Research and Education, University of California, San Francisco, San Francisco, CA.
Markey Cancer Center, University of Kentucky, Lexington, KY.
Nicotine Tob Res. 2020 Mar 16;22(3):332-338. doi: 10.1093/ntr/nty243.
Adolescence is a critical time when the majority of tobacco users initiate smoking. Contingency management for adolescent smoking cessation has shown promise in previous studies, but efficacy following removal of contingencies is not well understood. This study examined a remote form of contingency management among non-treatment-seeking adolescent smokers.
Participants (N = 127) submitted breath carbon monoxide (CO) three times daily throughout a 42-day program. For this randomized trial, participants in the active condition (n = 63) were reinforced for providing CO measurements on schedule and below a set criterion, whereas those in the control condition (n = 64) were reinforced for providing CO measurements on schedule. Self-reported smoking and urinary cotinine levels were collected at several timepoints.
Active condition showed greater within-group reductions in CO levels relative to control condition, but not at 3- or 6-month follow-up. Active condition reported significantly less smoking during treatment compared to control condition, but not at follow-up. There were no significant differences for urinary cotinine. Overall treatment adherence was low, with only 37% and 51% of possible CO samples being submitted among active and control, respectively. Poor treatment adherence may explain the disparity between CO and cotinine results, and poor follow-up treatment efficacy.
This study replicates feasibility of a remote form of contingency management for adolescent smoking. CO results suggest active condition reduced smoking within group, but treatment adherence and posttreatment efficacy was poor. Future research should focus on increasing adherence for this type of program among adolescent smokers.
This study demonstrates feasibility of a remote form of contingency management therapy for smoking cessation among adolescents, while providing posttreatment efficacy data. Within-group efficacy of this form of treatment is suggested, but treatment adherence and follow-up efficacy were poor. This study underscores the need for further development of contingency management therapy for adolescent smoking cessation, which emphasizes better treatment adherence and posttreatment efficacy.
青春期是大多数烟民开始吸烟的关键时期。在之前的研究中，青少年戒烟的条件管理已显示出前景，但在取消条件后其效果尚不清楚。本研究检查了一种非治疗性青少年吸烟者的远程条件管理形式。
参与者（N=127）在 42 天的计划中每天三次提交呼气一氧化碳（CO）。在这项随机试验中，主动组（n=63）的参与者因按时且低于设定标准提供 CO 测量值而得到强化，而对照组（n=64）的参与者因按时提供 CO 测量值而得到强化。在几个时间点收集自我报告的吸烟和尿液可替宁水平。
主动组的 CO 水平相对于对照组有更大的组内降低，但在 3 或 6 个月的随访中没有。主动组在治疗期间报告的吸烟量明显少于对照组，但在随访中没有。尿液可替宁无显著差异。总体治疗依从性较低，主动组和对照组分别只有 37%和 51%的可能 CO 样本提交。较差的治疗依从性可能解释了 CO 和可替宁结果之间的差异，以及较差的随访治疗效果。
本研究复制了一种远程形式的青少年吸烟行为条件管理的可行性。CO 结果表明，主动组在组内减少了吸烟，但治疗依从性和治疗后效果较差。未来的研究应集中在提高青少年吸烟者对这种类型计划的依从性。
本研究证明了一种远程形式的青少年戒烟条件管理治疗的可行性，同时提供了治疗后效果的数据。这种治疗形式的组内疗效是有希望的，但治疗依从性和随访效果较差。本研究强调了进一步开发青少年戒烟条件管理治疗的必要性，这种治疗方法强调了更好的治疗依从性和治疗后效果。
