Cigarette smoking has increased on college campuses nationwide by 28%. Over 80% of college smokers who have ever smoked regularly have attempted to quit, but 75% are unsuccessful. As the college years are a critical period in which young adults fully develop or renounce their smoking habit, an opportunity exists to intervene to promote smoking cessation and prevent a lifelong smoking habit. However, little is known about the effectiveness of smoking cessation interventions in a college student population. Toward this end, we propose a smoking cessation intervention directed toward 18-24 year old college student smokers. Behavioral Economic Theory guides the intervention. This theory suggests that to change smoking behavior, not only do the response costs of smoking and the response costs of quitting need to be addressed, but the alternative reinforcers to smoking need to be taken into consideration. This investigation will provide the first empirical test of Behavioral Economic Theory as it relates to smoking behavior in a naturalistic setting. The primary aim of the proposed study is to evaluate the impact of an experimental smoking cessation counseling intervention incorporating alternate reinforcers (SCC + AR) compared to a contact control smoking cessation-counseling condition (SCC). We also will examine whether the short-term and long-term impact of the experimental intervention on smoking cessation is mediated by increases in alternate reinforcers. Finally, we will evaluate whether depression symptoms and individual differences in how delayed rewards are valued (i.e., discounting) impact that benefits most from the intervention. After initial eligibility screening, participants will complete a pre-treatment assessment of smoking related and psychological variables. Subjects will participate in 6, 1.5-hour smoking cessation-counseling sessions. Mediating outcomes will be assessed at pre- and mid-treatment, 7 weeks, 6- and 12-months post target quit date. Smoking outcomes will be assessed at 7 weeks, and 6- and 12 months post target-quit date. The immediate goal of the present study is to test a novel theory and evaluate whether alternative reinforcers alter smoking cessation. The long-term objective is to provide information about a potentially more robust model of smoking behavior that can be applied to other populations (e.g., adolescents, older adults) and to other contexts (e.g., prevention).

National Institute of Health (NIH)
National Cancer Institute (NCI)
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Special Emphasis Panel (ZRG1-RPHB-2 (01))
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Marcus, Stephen
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University of Pennsylvania
Schools of Medicine
United States
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