A randomized controlled trial of contingency management for smoking cessation in substance use treatment patients.

Background/objective: Contingency management (CM) is one of the most effective interventions for smokers with substance use disorder (SUD), and no empirical assessment of its long-term efficacy has been conducted so far in a real-world context. The objectives were: (1) examine the additive effectiveness of CM on cognitive-behavioral treatment (CBT) for smoking cessation, and (2) examine the relationship between smoking cessation and substance use abstinence.

Method: A total of 80 participants (75.8% males;  = 45.31;  = 9.64) were assigned to two smoking cessation treatments: CBT or CBT+CM. A set of generalized estimating equations were conducted to examine the effect of treatment condition on smoking outcomes, as well as the effect of smoking status on substance abstinence.

Results: Adding CM to CBT for smoking cessation improved tobacco abstinence rates at the end-of-treatment ( = .049). Tobacco abstinence rates declined over time ( = .012), but no significant effects of treatment condition were observed across follow-ups ( = .260). Smoking cessation was not significantly related to substance abstinence ( ≥ .488).

Conclusions: CM facilitates early abstinence in smokers with SUD, although effects subside after treatment termination. The lack of association between smoking abstinence and substance use suggests no jeopardizing effects as a result of quitting smoking.