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Addressing Response Requirements and Behavioral Costs in Contingency Management for Smoking Cessation Brantley Phillip Jarvis James Madison University

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Addressing Response Requirements and Behavioral Costs in Contingency Management for Smoking Cessation Brantley Phillip Jarvis James Madison University James Madison University JMU Scholarly Commons Masters Theses The Graduate School Summer 2010 Addressing response requirements and behavioral costs in contingency management for smoking cessation Brantley Phillip Jarvis James Madison University Follow this and additional works at: https://commons.lib.jmu.edu/master201019 Part of the Psychology Commons Recommended Citation Jarvis, Brantley Phillip, "Addressing response requirements and behavioral costs in contingency management for smoking cessation" (2010). Masters Theses. 395. https://commons.lib.jmu.edu/master201019/395 This Thesis is brought to you for free and open access by the The Graduate School at JMU Scholarly Commons. It has been accepted for inclusion in Masters Theses by an authorized administrator of JMU Scholarly Commons. For more information, please contact [email protected]. Addressing Response Requirements and Behavioral Costs in Contingency Management for Smoking Cessation Brantley Phillip Jarvis A thesis submitted to the Graduate Faculty of JAMES MADISON UNIVERSITY In Partial Fulfillment of the Requirements for the degree of Master of Arts Department of Graduate Psychology August 2010 Acknowledgements First and foremost, I would like to thank my advisor and academic mentor Dr. Jessica Irons for her unwavering support and guidance over the past two years. Without her patience, hard work, and encouragement, this thesis would not be what it is. I am grateful to Dr. Sherry Serdikoff for introducing me to behavior analysis, for sparking my interests in scientific research, and for providing thoughtful feedback throughout all phases of this project. I would like to acknowledge Dr. Kevin Apple as well, for his helpful comments on the final draft of this manuscript. I would also like to recognize Brad Joachim, Kaitlin Balka, Liz Loveless, Allyson Vasi, Amanda Sorg, and Donna Melchione for assisting with data collection and providing suggestions on early paper drafts. ii Table of Contents Acknowledgments .............................................................................................................. ii List of Figures ......................................................................................................................v Abstract ............................................................................................................................. vii I. Chapter 1 ..................................................................................................................1 Smoking in the United States .......................................................................1 Nicotine Dependence ...................................................................................3 Common Smoking Cessation Treatments ....................................................4 II. Chapter 2 8 A Behavior-analytic View of Smoking .......................................................8 Contingency Management: Description and Efficacy ...............................16 CMSC: Payment Magnitudes and Arrangements ......................................21 CMSC: Contacting the Reinforcement Contingencies ..............................23 CMSC: Behavioral Requirements..............................................................26 III. Chapter 3 ................................................................................................................32 The Current Study ......................................................................................32 Method ...........................................................................................33 Participants .........................................................................33 Measures ............................................................................34 Self-report Measures ..............................................34 Biological Measures ...............................................37 Procedure ...........................................................................39 Intake/Baseline (Week 1) .......................................40 Contingency Management (CM; Weeks 2-4) ........40 Return to Baseline (Week 5) ..................................42 Return to CM (Week 6) .........................................43 Results ............................................................................................43 General Description of Sample ..........................................44 Participant 3 .......................................................................45 Biological Measures ...............................................45 Self-report Measures ..............................................46 Attendance and Earnings .......................................47 Participant 8 .......................................................................47 Biological Measures ...............................................47 Self-report Measures ..............................................48 Attendance and Earnings .......................................49 Participant 11 .....................................................................49 iii Biological Measures ...............................................49 Self-report Measures ..............................................50 Attendance and Earnings .......................................51 Participant 12 .....................................................................51 Biological Measures ...............................................51 Self-report Measures ..............................................52 Attendance and Earnings .......................................53 Participant 13 .....................................................................53 Biological Measures ...............................................53 Self-report Measures ..............................................54 Attendance and Earnings .......................................55 Participant 15 .....................................................................55 Biological Measures ...............................................55 Self-report Measures ..............................................56 Attendance and Earnings .......................................57 IV. Chapter 4 ................................................................................................................58 Discussion ..................................................................................................58 Limitations of the Current Study and Future Directions ...............59 Failure to Establish Baseline Smoking Levels ...................59 Weaknesses of Reversal Designs Using CM .....................62 Practical Drawbacks of Smoking Measurement ................64 Payment Magnitudes and Cost-effectiveness ....................66 Delayed Payments ..............................................................68 Payment Arrangements ......................................................70 Conclusion .....................................................................................72 V. Footnotes ................................................................................................................74 VI. Appendices .............................................................................................................75 Appendix A: Demographics Questionnaire ...............................................75 Appendix B: Smoking Behavior Questionnaire ........................................76 Appendix C: Hooked on Nicotine Checklist .............................................78 Appendix D: Fagerstrom Test for Nicotine Dependence ..........................79 Appendix E: Wisconsin Smoking Withdrawal Scale ................................80 Appendix F: Contemplation Ladder ..........................................................81 Appendix G: Daily Tobacco Report ..........................................................82 Appendix H: Vitalograph Breath CO ........................................................83 Appendix I: NicCheckTM I Test Strips .......................................................84 Appendix J: Debriefing Statement .............................................................88 VII. References ..............................................................................................................89 iv List of Figures Figure 1: Expired Breath CO across All Condition Weeks for Participant 3 ..................107 Figure 2: Urinalysis Scores across All Condition Weeks for Participant 3 .....................108 Figure 3: Self-reported Daily Number of Cigarettes Smoked since the Previous Session across All Condition Weeks for Participant 3..................................................................109 Figure 4: Self-reported Time in Minutes since Last Smoking a Cigarette across All Condition Weeks for Participant 3 ...................................................................................110 Figure 5: Expired Breath CO across All Condition Weeks for Participant 8 ..................111 Figure 6: Urinalysis Scores across All Condition Weeks for Participant 8 .....................112 Figure 7: Self-reported Daily Number of Cigarettes Smoked since the Previous Session across All Condition Weeks for Participant 8..................................................................113 Figure 8: Self-reported Time in Minutes since Last Smoking a Cigarette across All Condition Weeks for Participant 8 ...................................................................................114 Figure 9: Expired Breath CO across All Condition Weeks for Participant 11 ................115
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