Document Detail


Effects of smoking cessation with voucher-based contingency management on birth outcomes.
MedLine Citation:
PMID:  20840188     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: This study examined whether smoking cessation using voucher-based contingency management (CM) improves birth outcomes.
DESIGN: Data were combined from three controlled trials.
SETTING: Each of the trials was conducted in the same research clinic devoted to smoking and pregnancy.
PARTICIPANTS: Participants (n=166) were pregnant women who participated in trials examining the efficacy of voucher-based CM for smoking cessation. Women were assigned to either a contingent condition, wherein they earned vouchers exchangeable for retail items by abstaining from smoking, or to a non-contingent condition where they received vouchers independent of smoking status.
MEASUREMENT: Birth outcomes were determined by review of hospital delivery records.
FINDINGS: Antepartum abstinence was greater in the contingent than non-contingent condition, with late-pregnancy abstinence being 34.1% versus 7.4% (P<0.001). Mean birth weight of infants born to mothers treated in the contingent condition was greater than infants born to mothers treated in the non-contingent condition (3295.6 ± 63.8 g versus 3093.6 ± 67.0 g, P = 0.03) and the percentage of low birth weight (<2500 g) deliveries was less (5.9% versus 18.5%, P = 0.02). No significant treatment effects were observed across three other outcomes investigated, although each was in the direction of improved outcomes in the contingent versus the non-contingent condition: mean gestational age (39.1 ± 0.2 weeks versus 38.5 ± 0.3 weeks, P = 0.06), percentage of preterm deliveries (5.9 versus 13.6, P = 0.09), and percentage of admissions to the neonatal intensive care unit (4.7% versus 13.8%, P = 0.06).
CONCLUSIONS: These results provide evidence that smoking-cessation treatment with voucher-based CM may improve important birth outcomes.
Authors:
Stephen T Higgins; Ira M Bernstein; Yukiko Washio; Sarah H Heil; Gary J Badger; Joan M Skelly; Tara M Higgins; Laura J Solomon
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2010-09-15
Journal Detail:
Title:  Addiction (Abingdon, England)     Volume:  105     ISSN:  1360-0443     ISO Abbreviation:  Addiction     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-02     Completed Date:  2011-04-28     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  9304118     Medline TA:  Addiction     Country:  England    
Other Details:
Languages:  eng     Pagination:  2023-30     Citation Subset:  IM    
Copyright Information:
© 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.
Affiliation:
Department of Psychiatry, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, USA. stephen.higgins@uvm.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Birth Weight*
Child
Female
Gestational Age
Humans
Infant, Low Birth Weight
Infant, Newborn
Intensive Care Units, Neonatal
Linear Models
Patient Admission / statistics & numerical data
Pilot Projects
Pregnancy
Premature Birth / epidemiology
Smoking / adverse effects,  therapy*
Smoking Cessation / methods*
Token Economy*
Treatment Outcome
Young Adult
Grant Support
ID/Acronym/Agency:
DA007242/DA/NIDA NIH HHS; DA14028/DA/NIDA NIH HHS; M01 RR000109-445441/RR/NCRR NIH HHS; M01RR109/RR/NCRR NIH HHS; R01 DA014028-09/DA/NIDA NIH HHS; T32 DA007242-19/DA/NIDA NIH HHS
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