A pilot trial of behavioural activation with a contingency management component: Preliminary examination of changes in smoking and alternative rewards among low‐income individuals

Abstract

The heaviest smoking and burden of tobacco‐related illness occurs among low‐income individuals. Using a behavioural economics framework, this non‐randomised pilot study examined the preliminary efficacy of behavioural activation (BA) with a contingency management (CM) component designed to encourage continued use of BA skills and reductions in cigarettes smoked. Eighty‐four participants were recruited from a community centre. Data were collected at the start of every other group and at four different follow‐up time points. Domains assessed included number of cigarettes smoked, activity level, and environmental rewards (i.e. alternative environmental reinforcers). Over time, cigarette smoking decreased (p < .001), environmental reward increased (p = .03), and reward probability and activity level were associated over time with cigarette smoking (p ≤ .03) above and beyond the effect of nicotine dependence. The continued use of BA skills was associated with greater environmental rewards (p = .04). While further research is needed to replicate this work, results suggest initial evidence for the utility of this intervention in a traditionally underserved community.