Influence of the duration of abstinence on the relative reinforcing effects of cigarette smoking.

RATIONALE: Sustaining smoking abstinence during the initial weeks of a cessation effort is highly correlated with long-term smoking abstinence. However, experimental research is needed to establish a direct causal relationship between achieving early abstinence and lowered relapse risk.
OBJECTIVE: In the present study, we tested whether a period of sustained abstinence directly decreases the relative reinforcing effects of cigarette smoking.
METHODS: Participants were 63 adult smokers who were randomized into one of three conditions: 14-day (14C), 7-day (7C), and 1-day (1C) contingent payment for smoking abstinence. Smoking status was assessed three times per day for 14 consecutive days using breath carbon monoxide monitoring and an abstinence criterion of < or = 4 ppm. In the 14C condition, monetary payment was contingent on abstinence for all 14 days; in the 7C condition, payment was noncontingent for days 1-7 and contingent for days 8-14; in the 1C condition, payment was noncontingent for days 1-13 and contingent for day 14. On day 14, all participants completed a 3-h preference session under controlled laboratory conditions wherein they could make a maximum of 20 exclusive choices between options to smoke (two puffs/choice) or earn money (0.25 dollars/choice). Preference was deemed an index of the relative reinforcing effects of smoking and money.
RESULTS: A significantly lower proportion of participants in the 14C condition ever chose the smoking option (19%) compared to those in the 7C (57%) or 1C (62%) conditions.
CONCLUSIONS: These results provide experimental evidence that sustained abstinence can decrease the relative reinforcing effects of smoking, an effect that may be related to the commonly observed decrease in relapse risk among those who are able to sustain smoking abstinence during the initial weeks of a cessation effort.

RCT Entities:   Population Interventions Outcomes