An Internet-based abstinence reinforcement treatment for cigarette smoking

Although voucher reinforcement has been shown to promote abstinence from smoking, more practical methods are needed to obtain objective evidence of smoking status on a frequent and sustained basis. Using a within-subject reversal design, the present study tested an Internet-based method to obtain objective evidence of smoking status and to deliver voucher incentives for evidence of abstinence. Twenty (10 females) heavy smokers completed this 4-week study. Twice daily, participants made video recordings of themselves providing a breath carbon monoxide (CO) sample with a web camera. The video was made at home and sent electronically to the smoking clinic. Participants could earn vouchers for gradual reductions in breath CO during a 4-day shaping condition, and then for achieving abstinence (CO ≤ 7 ppm) during a 10-day abstinence induction phase. Vouchers could be exchanged for merchandise at select Internet vendors. Relative to baseline conditions, significant decreases in CO were observed during treatment, and many participants achieved sustained periods of abstinence. The study suggests that an Internet-based voucher reinforcement program is a feasible and effective method to promote abstinence from cigarette smoking.