Contingency management for smokers with mental health disorders and smoking-sensitive conditions caused or exacerbated by tobacco use: A review of existing studies, intervention parameters, and research priorities.

Cigarette smoking is highly prevalent in people with smoking-sensitive conditions and mental health disorders. As early as the 1960s, evidence indicated the efficacy of contingency management (CM) for smoking cessation in various populations. This invited review is a critical appraisal of existing CM studies on smoking cessation in populations presenting smoking-sensitive conditions. It is particularly focused on examining the differences between two populations: smokers presenting health-related conditions and smokers with mental health disorders. Smoking abstinence is discussed in relation to treatment parameters (duration of interventions, schedules of reinforcement, and adjunctive therapies). A systematic review was conducted using PubMed, PsycINFO, and Scopus databases in December 2021. A total of 18 studies ( = 1,697; weighted age: 48.66 (8.57); % females: 41) were included in this review. Populations included hospitalized patients, smokers with chronic obstructive pulmonary disease (COPD), overweight, cancer, mood disorders, attentional deficits, psychosis, and posttraumatic stress disorder. CM abstinence rates were 43.04% at the earliest follow-up assessment (i.e., end of treatment-15 weeks) and 23.28% at subsequent follow-ups (10 days to 1-year posttreatment). Virtually all of the CM studies used cash as a reinforcer and were in place for an average of 5.53 weeks. Incremental versus fixed reinforcement schedules are more commonly used to promote smoking abstinence, but there are still not enough sufficiently powered and well-designed (active vs. control) studies to clarify the optimal magnitude and frequency of incentives. Dismantling studies are needed to refine the CM parameters most likely to produce enduring abstinence. (PsycInfo Database Record (c) 2023 APA, all rights reserved).