Greater perceived importance of earning abstinence-contingent incentives is associated with smoking cessation among socioeconomically disadvantaged adults

Background: Individuals' perceptions of the importance of earning financial incentives for smoking cessation may influence the effectiveness of contingency management interventions. This study prospectively explored the perceived importance of earning financial incentives for smoking cessation and its association with smoking cessation within a contingency management intervention among socioeconomically disadvantaged adults. Methods: This study is a secondary analysis of data from a randomized clinical trial that recruited socioeconomically disadvantaged adults from a safety-net hospital in Dallas County, Texas, from 2011 to 2013. Participants, who were randomly assigned to receive small financial incentives for smoking abstinence (N = 75), rated the importance of earning abstinence-contingent financial incentives one day after their scheduled quit day and one-week post-quit day. Self-reported smoking abstinence was biochemically confirmed weekly through the fourth week post-quit day and at the twelfth week post-quit day. Participants were considered continuously abstinent if self-reported abstinence since the quit date was biochemically confirmed. Results: Greater perceived importance of earning abstinence contingent incentives for smoking cessation was associated with a higher likelihood of achieving continuous abstinence during the four-week intervention period (OR = 3.95 [95% CI = 1.64, 9.53]) and through 12 weeks post-quit day (OR = 4.71 [95% CI = 1.56, 14.26]). Conclusions: Findings suggest that the perceived importance of earning abstinence-contingent incentives early in a quit attempt predicts smoking cessation among socioeconomically disadvantaged adults and may indicate whether an individual will be responsive to the magnitude of incentives offered.