Trial Outcomes & Findings for Financial Incentives for Smoking Cessation Among Mothers (NCT NCT05740098)

NCT ID: NCT05740098

Last Updated: 2023-07-28

Results Overview

Point prevalence abstinence will be defined as self-report of no smoking in the past 7 days, not even a puff, with biochemical verification via breath carbon monoxide (CO) and urine cotinine. Abstinence at the 12-week (end of treatment) and 24-week assessment will be compared between the three treatment arms.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

198 participants

Primary outcome timeframe

Collected once per woman at approximately 12- and 24- weeks following quit date in each of the three smoking arms

Results posted on

2023-07-28

Participant Flow

Participant milestones

Participant milestones
Measure
Best Practices
Participants will receive the Five As plus a referral to a quit line. Best Practices: Five As plus referral to a quit line
Best Practices and Financial Incentives
Participants will receive the Five As, a referral to a quit line, and financial incentives contingent on biochemically confirmed smoking abstinence Best Practices: Five As plus referral to a quit line Financial Incentives: Financial incentives provided contingent on biochemically confirmed smoking abstinence. Incentives are in the form of vouchers exchangeable for retail items and available through 12-weeks following quit date.
Best Practices, Financial Incentives, and NRT
Participants will receive the Five As, a referral to a quit line, financial incentives contingent on biochemically confirmed smoking abstinence, and nicotine replacement therapy (NRT) provided in the form of both nicotine patches and gum/lozenge for dual therapy. Best Practices: Five As plus referral to a quit line Financial Incentives: Financial incentives provided contingent on biochemically confirmed smoking abstinence. Incentives are in the form of vouchers exchangeable for retail items and available through 12-weeks following quit date. Nicotine Replacement Therapy: Nicotine patches and gum/lozenge provided together for dual therapy
Overall Study
STARTED
68
63
67
Overall Study
COMPLETED
42
46
46
Overall Study
NOT COMPLETED
26
17
21

Reasons for withdrawal

Reasons for withdrawal
Measure
Best Practices
Participants will receive the Five As plus a referral to a quit line. Best Practices: Five As plus referral to a quit line
Best Practices and Financial Incentives
Participants will receive the Five As, a referral to a quit line, and financial incentives contingent on biochemically confirmed smoking abstinence Best Practices: Five As plus referral to a quit line Financial Incentives: Financial incentives provided contingent on biochemically confirmed smoking abstinence. Incentives are in the form of vouchers exchangeable for retail items and available through 12-weeks following quit date.
Best Practices, Financial Incentives, and NRT
Participants will receive the Five As, a referral to a quit line, financial incentives contingent on biochemically confirmed smoking abstinence, and nicotine replacement therapy (NRT) provided in the form of both nicotine patches and gum/lozenge for dual therapy. Best Practices: Five As plus referral to a quit line Financial Incentives: Financial incentives provided contingent on biochemically confirmed smoking abstinence. Incentives are in the form of vouchers exchangeable for retail items and available through 12-weeks following quit date. Nicotine Replacement Therapy: Nicotine patches and gum/lozenge provided together for dual therapy
Overall Study
Lost to Follow-up
26
17
21

Baseline Characteristics

Financial Incentives for Smoking Cessation Among Mothers

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Best Practices
n=68 Participants
Participants will receive the Five As plus a referral to a quit line. Best Practices: Five As plus referral to a quit line
Best Practices and Financial Incentives
n=63 Participants
Participants will receive the Five As, a referral to a quit line, and financial incentives contingent on biochemically confirmed smoking abstinence Best Practices: Five As plus referral to a quit line Financial Incentives: Financial incentives provided contingent on biochemically confirmed smoking abstinence. Incentives are in the form of vouchers exchangeable for retail items and available through 12-weeks following quit date.
Best Practices, Financial Incentives, and NRT
n=67 Participants
Participants will receive the Five As, a referral to a quit line, financial incentives contingent on biochemically confirmed smoking abstinence, and nicotine replacement therapy (NRT) provided in the form of both nicotine patches and gum/lozenge for dual therapy. Best Practices: Five As plus referral to a quit line Financial Incentives: Financial incentives provided contingent on biochemically confirmed smoking abstinence. Incentives are in the form of vouchers exchangeable for retail items and available through 12-weeks following quit date. Nicotine Replacement Therapy: Nicotine patches and gum/lozenge provided together for dual therapy
Total
n=198 Participants
Total of all reporting groups
Age, Continuous
32.95 years
STANDARD_DEVIATION 5.86 • n=5 Participants
31.82 years
STANDARD_DEVIATION 6.18 • n=7 Participants
32.88 years
STANDARD_DEVIATION 6.50 • n=5 Participants
32.56 years
STANDARD_DEVIATION 6.17 • n=4 Participants
Sex: Female, Male
Female
68 Participants
n=5 Participants
63 Participants
n=7 Participants
67 Participants
n=5 Participants
198 Participants
n=4 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race/Ethnicity, Customized
Non-Hispanic White
60 Participants
n=5 Participants
57 Participants
n=7 Participants
60 Participants
n=5 Participants
177 Participants
n=4 Participants
Race/Ethnicity, Customized
Other
8 Participants
n=5 Participants
6 Participants
n=7 Participants
7 Participants
n=5 Participants
21 Participants
n=4 Participants
Region of Enrollment
United States
68 participants
n=5 Participants
63 participants
n=7 Participants
67 participants
n=5 Participants
198 participants
n=4 Participants
Maternal smoking status
Smoking
68 Participants
n=5 Participants
63 Participants
n=7 Participants
67 Participants
n=5 Participants
198 Participants
n=4 Participants
Maternal smoking status
non-smoker
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants

PRIMARY outcome

Timeframe: Collected once per woman at approximately 12- and 24- weeks following quit date in each of the three smoking arms

Point prevalence abstinence will be defined as self-report of no smoking in the past 7 days, not even a puff, with biochemical verification via breath carbon monoxide (CO) and urine cotinine. Abstinence at the 12-week (end of treatment) and 24-week assessment will be compared between the three treatment arms.

Outcome measures

Outcome measures
Measure
Best Practices
n=68 Participants
Participants will receive the Five As plus a referral to a quit line. Best Practices: Five As plus referral to a quit line
Best Practices and Financial Incentives
n=63 Participants
Participants will receive the Five As, a referral to a quit line, and financial incentives contingent on biochemically confirmed smoking abstinence Best Practices: Five As plus referral to a quit line Financial Incentives: Financial incentives provided contingent on biochemically confirmed smoking abstinence. Incentives are in the form of vouchers exchangeable for retail items and available through 12-weeks following quit date.
Best Practices, Financial Incentives, and NRT
n=67 Participants
Participants will receive the Five As, a referral to a quit line, financial incentives contingent on biochemically confirmed smoking abstinence, and nicotine replacement therapy (NRT) provided in the form of both nicotine patches and gum/lozenge for dual therapy. Best Practices: Five As plus referral to a quit line Financial Incentives: Financial incentives provided contingent on biochemically confirmed smoking abstinence. Incentives are in the form of vouchers exchangeable for retail items and available through 12-weeks following quit date. Nicotine Replacement Therapy: Nicotine patches and gum/lozenge provided together for dual therapy
7-day Point Prevalence Smoking Abstinence Levels
12 weeks
4 Participants
22 Participants
18 Participants
7-day Point Prevalence Smoking Abstinence Levels
24 weeks
6 Participants
14 Participants
12 Participants

PRIMARY outcome

Timeframe: Collected twice per child at baseline, and once at approximately 6-, 12- and 24-weeks following quit date

Population: This analysis is based on only children who submitted a baseline and at least one valid urine specimen between Weeks 6-24. Note that numbers in the Overall Participant Flow pertains to mothers while those shown in this section pertain to children.

SHSe will be defined as the level of cotinine measured in the urine of the youngest child at baseline, 6-, 12-, and 24-weeks following the mother's quit date. SHSe outcomes will be compared between the three treatment arms and between children of abstainers versus smokers independent of treatment condition. We hypothesize being able to detect greater reductions from baseline levels in the incentives compared to Best Practices treatment conditions and among abstainers compared to smokers. We report main effects of treatment condition as geometric means (+/- SEM) collapsed across the three assessment times for each treatment condition controlling for baseline values.

Outcome measures

Outcome measures
Measure
Best Practices
n=52 Participants
Participants will receive the Five As plus a referral to a quit line. Best Practices: Five As plus referral to a quit line
Best Practices and Financial Incentives
n=47 Participants
Participants will receive the Five As, a referral to a quit line, and financial incentives contingent on biochemically confirmed smoking abstinence Best Practices: Five As plus referral to a quit line Financial Incentives: Financial incentives provided contingent on biochemically confirmed smoking abstinence. Incentives are in the form of vouchers exchangeable for retail items and available through 12-weeks following quit date.
Best Practices, Financial Incentives, and NRT
n=51 Participants
Participants will receive the Five As, a referral to a quit line, financial incentives contingent on biochemically confirmed smoking abstinence, and nicotine replacement therapy (NRT) provided in the form of both nicotine patches and gum/lozenge for dual therapy. Best Practices: Five As plus referral to a quit line Financial Incentives: Financial incentives provided contingent on biochemically confirmed smoking abstinence. Incentives are in the form of vouchers exchangeable for retail items and available through 12-weeks following quit date. Nicotine Replacement Therapy: Nicotine patches and gum/lozenge provided together for dual therapy
Objective Measure of Child Secondhand Smoke Exposure (SHSe)
3.53 ng/ml
Standard Error 0.96
3.48 ng/ml
Standard Error 0.92
8.49 ng/ml
Standard Error 2.22

SECONDARY outcome

Timeframe: 24 weeks following quit date

Continuous abstinence will be defined as self-report of no smoking in the past 7 days at each time point, not even a puff, with biochemical verification via breath CO and urine cotinine. Continuous abstinence from quit date through 24 week assessment will be compared between the three treatment arms.

Outcome measures

Outcome measures
Measure
Best Practices
n=68 Participants
Participants will receive the Five As plus a referral to a quit line. Best Practices: Five As plus referral to a quit line
Best Practices and Financial Incentives
n=63 Participants
Participants will receive the Five As, a referral to a quit line, and financial incentives contingent on biochemically confirmed smoking abstinence Best Practices: Five As plus referral to a quit line Financial Incentives: Financial incentives provided contingent on biochemically confirmed smoking abstinence. Incentives are in the form of vouchers exchangeable for retail items and available through 12-weeks following quit date.
Best Practices, Financial Incentives, and NRT
n=67 Participants
Participants will receive the Five As, a referral to a quit line, financial incentives contingent on biochemically confirmed smoking abstinence, and nicotine replacement therapy (NRT) provided in the form of both nicotine patches and gum/lozenge for dual therapy. Best Practices: Five As plus referral to a quit line Financial Incentives: Financial incentives provided contingent on biochemically confirmed smoking abstinence. Incentives are in the form of vouchers exchangeable for retail items and available through 12-weeks following quit date. Nicotine Replacement Therapy: Nicotine patches and gum/lozenge provided together for dual therapy
Continuous Abstinence
3 Participants
12 Participants
10 Participants

SECONDARY outcome

Timeframe: 48 weeks following quit date

Point prevalence abstinence will be defined as self-report of no smoking in the past 7 days, not even a puff, with biochemical verification via breath CO and urine cotinine. We will use this data to estimate relapse rates across treatment arms and for use in comparing SHSe levels in children of abstainers versus smokers.

Outcome measures

Outcome measures
Measure
Best Practices
n=68 Participants
Participants will receive the Five As plus a referral to a quit line. Best Practices: Five As plus referral to a quit line
Best Practices and Financial Incentives
n=63 Participants
Participants will receive the Five As, a referral to a quit line, and financial incentives contingent on biochemically confirmed smoking abstinence Best Practices: Five As plus referral to a quit line Financial Incentives: Financial incentives provided contingent on biochemically confirmed smoking abstinence. Incentives are in the form of vouchers exchangeable for retail items and available through 12-weeks following quit date.
Best Practices, Financial Incentives, and NRT
n=67 Participants
Participants will receive the Five As, a referral to a quit line, financial incentives contingent on biochemically confirmed smoking abstinence, and nicotine replacement therapy (NRT) provided in the form of both nicotine patches and gum/lozenge for dual therapy. Best Practices: Five As plus referral to a quit line Financial Incentives: Financial incentives provided contingent on biochemically confirmed smoking abstinence. Incentives are in the form of vouchers exchangeable for retail items and available through 12-weeks following quit date. Nicotine Replacement Therapy: Nicotine patches and gum/lozenge provided together for dual therapy
7-day Point Prevalence Abstinence at 48-week Follow-up Assessment
5 Participants
11 Participants
6 Participants

SECONDARY outcome

Timeframe: Assessed once per woman at 6-, 12-, 24-, and 48-weeks following quit date.

Population: Participants who completed a valid baseline delay-discounting assessment. Six participants did not have a valid assessment making total N 192 rather than 198 participants. Analyses tested for interactions of treatment and delay discounting. If there is a significant interaction (P \< 0.05) of treatment condition and baseline delay discounting, we report results separately by treatment condition. In the absence of significant interactions, we collapse results across treatment conditions.

Biochemically-verified 7-day point-prevalence smoking abstinence.

Outcome measures

Outcome measures
Measure
Best Practices
n=192 Participants
Participants will receive the Five As plus a referral to a quit line. Best Practices: Five As plus referral to a quit line
Best Practices and Financial Incentives
Participants will receive the Five As, a referral to a quit line, and financial incentives contingent on biochemically confirmed smoking abstinence Best Practices: Five As plus referral to a quit line Financial Incentives: Financial incentives provided contingent on biochemically confirmed smoking abstinence. Incentives are in the form of vouchers exchangeable for retail items and available through 12-weeks following quit date.
Best Practices, Financial Incentives, and NRT
Participants will receive the Five As, a referral to a quit line, financial incentives contingent on biochemically confirmed smoking abstinence, and nicotine replacement therapy (NRT) provided in the form of both nicotine patches and gum/lozenge for dual therapy. Best Practices: Five As plus referral to a quit line Financial Incentives: Financial incentives provided contingent on biochemically confirmed smoking abstinence. Incentives are in the form of vouchers exchangeable for retail items and available through 12-weeks following quit date. Nicotine Replacement Therapy: Nicotine patches and gum/lozenge provided together for dual therapy
Smoking Abstinence
# abstinent 48-wks
22 Participants
Smoking Abstinence
# abstinent 6-wks
49 Participants
Smoking Abstinence
# abstinent 12-wks
44 Participants
Smoking Abstinence
# abstinent 24-wks
32 Participants

SECONDARY outcome

Timeframe: Collected once per woman at baseline, 6-, 12-, 24-, and 48-weeks following quit date.

Population: Participants who completed a valid baseline Cigarette-Purchase-Task (CPT) assessment. Ten participants did not have a valid assessment making total N 188 rather than 198 participants. Analyses tested for interactions of treatment and CPT Latent Factors. If there is a significant interaction (P \< 0.05) of treatment condition and CPT Latent Factors, we report results separately by treatment condition. In the absence of significant interactions, we collapse results across treatment conditions.

Biochemically-verified 7-day point-prevalence smoking abstinence.

Outcome measures

Outcome measures
Measure
Best Practices
n=188 Participants
Participants will receive the Five As plus a referral to a quit line. Best Practices: Five As plus referral to a quit line
Best Practices and Financial Incentives
Participants will receive the Five As, a referral to a quit line, and financial incentives contingent on biochemically confirmed smoking abstinence Best Practices: Five As plus referral to a quit line Financial Incentives: Financial incentives provided contingent on biochemically confirmed smoking abstinence. Incentives are in the form of vouchers exchangeable for retail items and available through 12-weeks following quit date.
Best Practices, Financial Incentives, and NRT
Participants will receive the Five As, a referral to a quit line, financial incentives contingent on biochemically confirmed smoking abstinence, and nicotine replacement therapy (NRT) provided in the form of both nicotine patches and gum/lozenge for dual therapy. Best Practices: Five As plus referral to a quit line Financial Incentives: Financial incentives provided contingent on biochemically confirmed smoking abstinence. Incentives are in the form of vouchers exchangeable for retail items and available through 12-weeks following quit date. Nicotine Replacement Therapy: Nicotine patches and gum/lozenge provided together for dual therapy
Smoking Abstinence
# abstinent 6-wks
49 Participants
Smoking Abstinence
# abstinent 12-wks
44 Participants
Smoking Abstinence
# abstinent 24-wks
32 Participants
Smoking Abstinence
# abstinent 48-wks
22 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: 48 weeks following quit date.

Population: Data collection on this outcome was to occur following completion of data collection on treatment outcomes. The COVID pandemic prevented data collection on this outcome.

Number of outpatient child visits will be compared between the three treatment arms and between abstainers versus smokers, independent of treatment condition.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: 48 weeks following quit date.

Population: Data collection on this outcome was to occur following completion of data collection on treatment outcomes. The COVID pandemic prevented data collection on this outcome.

Number of inpatient child visits will be compared between the three treatment arms and between abstainers versus smokers, independent of treatment condition.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: 48 weeks following quit date.

Population: Data collection on this outcome was to occur following completion of data collection on treatment outcomes. The COVID pandemic prevented data collection on this outcome.

Number of times child received prescription medications will be compared between the three treatment arms and between abstainers versus smokers, independent of treatment condition.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Study entry through 48 weeks following quit date.

Population: Cost-effectiveness analysis was not conducted because data collection on necessary outcomes was not completed due to the COVID pandemic.

Cost-effectiveness will include the cost of each intervention, measured by the Brief Drug Abuse Treatment Cost Analysis Program (Brief-DATCAP) and the economic cost of treatment (fixed costs based upon proportion of time and/or space utilized by the program). Estimated treatment costs will be combined with estimated child healthcare utilization costs to represent total costs per treatment condition. Treatment costs will be compared across the three treatment arms.

Outcome measures

Outcome data not reported

Adverse Events

Best Practices

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Best Practices and Financial Incentives

Serious events: 1 serious events
Other events: 0 other events
Deaths: 0 deaths

Best Practices, Financial Incentives, and NRT

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Best Practices
n=68 participants at risk
Participants will receive the Five As plus a referral to a quit line. Best Practices: Five As plus referral to a quit line
Best Practices and Financial Incentives
n=63 participants at risk
Participants will receive the Five As, a referral to a quit line, and financial incentives contingent on biochemically confirmed smoking abstinence Best Practices: Five As plus referral to a quit line Financial Incentives: Financial incentives provided contingent on biochemically confirmed smoking abstinence. Incentives are in the form of vouchers exchangeable for retail items and available through 12-weeks following quit date.
Best Practices, Financial Incentives, and NRT
n=67 participants at risk
Participants will receive the Five As, a referral to a quit line, financial incentives contingent on biochemically confirmed smoking abstinence, and nicotine replacement therapy (NRT) provided in the form of both nicotine patches and gum/lozenge for dual therapy. Best Practices: Five As plus referral to a quit line Financial Incentives: Financial incentives provided contingent on biochemically confirmed smoking abstinence. Incentives are in the form of vouchers exchangeable for retail items and available through 12-weeks following quit date. Nicotine Replacement Therapy: Nicotine patches and gum/lozenge provided together for dual therapy
Gastrointestinal disorders
Serious Adverse event
0.00%
0/68 • Adverse event data were collected across 48 weeks following study entry for each participant.
1.6%
1/63 • Number of events 1 • Adverse event data were collected across 48 weeks following study entry for each participant.
0.00%
0/67 • Adverse event data were collected across 48 weeks following study entry for each participant.

Other adverse events

Adverse event data not reported

Additional Information

Stephen T. Higgins, PhD., P.I.

University of Vermont

Phone: 802-656-9615

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place