Preliminary Test of Reactive Carrot Incentives in a Practice Quit Environment with Contingency Management Incentives
Last registered on June 01, 2021

Pre-Trial

Trial Information
General Information
Title
Preliminary Test of Reactive Carrot Incentives in a Practice Quit Environment with Contingency Management Incentives
RCT ID
AEARCTR-0007612
Initial registration date
May 31, 2021
Last updated
June 01, 2021 10:30 AM EDT
Location(s)

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Primary Investigator
Affiliation
Yale Law School
Other Primary Investigator(s)
PI Affiliation
PI Affiliation
PI Affiliation
Additional Trial Information
Status
In development
Start date
2021-05-01
End date
2021-12-31
Secondary IDs
Abstract
This initial study is intended to demonstrate the feasibility of implementing a “reactive carrot” intervention for individuals in a “practice quit” program. All the subjects, treatment and control groups, would be enrolled in a “practice quit” program where they would agree to try to not smoke cigarettes for a period of 2 weeks and all subjects (both treatment and control groups) would be given the opportunity to receive attendance rewards for attending six CO testing meetings as well as abstention (contingency management) rewards for abstaining from smoking. The only difference between the subjects randomly assigned to treatment and control groups is that each member of the treatment group would be tempted at the beginning of their program by being offered a one-time monetary incentive to forego the opportunity to receive subsequent abstention (contingency management) rewards. As explained below more fully, treatment group subjects would, at their initial intake meeting after the attendance and abstention rewards opportunity had been described, be given a one-time opportunity to received $80 temptation payment to give up the opportunity to receive subsequent abstinence (contingency management) rewards that could be worth as much as $165. Subjects who accepted this one-time opportunity would remain enrolled in the practice quit smoking and they would still be eligible to receive attendance reward compensation totaling up to $30 for showing up to their six testing appointments. The purpose of the study is to test whether resisting the temptation to accept the one-time payment helps steel the resolve of the treatment subjects to follow through and make sure that they earn the subsequent contingency management rewards. More specifically, an intent-to-treat design will allow us to test whether the temptation causes treatment group subjects to have greater success than the un-tempted control group subjects to abstain from smoking during the two-week practice quit period.
External Link(s)
Registration Citation
Citation
Ayres, Ian et al. 2021. "Preliminary Test of Reactive Carrot Incentives in a Practice Quit Environment with Contingency Management Incentives." AEA RCT Registry. June 01. https://doi.org/10.1257/rct.7612-1.0.
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Experimental Details
Interventions
Intervention(s)
All the subjects, treatment and control groups, would be enrolled in a “practice quit” program where they would agree to try to not smoke cigarettes for a period of 2 weeks and all subjects (both treatment and control groups) would be given the opportunity to receive attendance rewards for attending six CO testing meetings as well as abstention (contingency management) rewards for abstaining from smoking. The only difference between the subjects randomly assigned to treatment and control groups is that each member of the treatment group would be tempted at the beginning of their program by being offered a one-time monetary incentive to forego the opportunity to receive subsequent abstention (contingency management) rewards.
Intervention Start Date
2021-05-01
Intervention End Date
2021-12-31
Primary Outcomes
Primary Outcomes (end points)
The main outcome variable will be results from a breath Carbon Monoxide test. Abstinence will be coded as expired-air carbon monoxide (CO) levels below 5 ppm (as suggested measure in literature (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3733388/) to assure 24 hour abstinence).
Primary Outcomes (explanation)
Secondary Outcomes
Secondary Outcomes (end points)
(1) Whether subjects attend their CO testing appointments.
(2) Total amount of abstention (contingency management) rewards paid to subjects.
(3) Whether subjects report reduced smoking
(4) Time to first relapse
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
This practice quit study will take place in two different locations—New Haven, CT and Kiev, Ukraine. Participants for the New Haven Trial will be recruited from general public and from Yale’s Tobacco Treatment Service from April 2021 to December 31, 2021. Participants for the Kiev trial will also be recruited from the general public using ads on socia media and pamphleting at local markets during the same period.
The study procedures for the two trial will be identical except that (1) the New Haven trial’s intake and CO testing will be done remotely while the Kiev location will have in-person meetings with subject participations and (2) the specific attendance and abstinence rewards described in detail below will be denominated in local currency.
We will include individuals who are adults and smoke more than 3 cigaretters per week and exclude individuals that have unstable psychiatric/medical conditions (see below for details on the exclusion criteria). At an initial intake meeting, research staff would inform patients about the study. Those who expressed interest would complete informed consent, baseline assessments, and a breath carbon monoxide (CO) reading (Bedfont Micro+ Smokerlyzer) to verify smoking status (i.e., defined as >4ppm).
At this intake appointment, patients would be randomized into the two arms, with blocking stratification by Fagerstrom scores. As suggested in the literature, participants would be placed in high nicotine dependence group if Fagerstrom score was greater than 5 (and in low dependence group if their score was below this cutoff) (Schnoll et al 2013). Allocation would be concealed, and each participant would be assigned the next sequential number by a research staff member who was blinded to the allocation sequence using Redcap.
Remote CO testing will be done using breathalyzers that connect with the participants’ phone. An administrator will observe the participant taking each CO test via Zoom.
Experimental Design Details
Not available
Randomization Method
Randomized
Randomization Unit
individual
Was the treatment clustered?
No
Experiment Characteristics
Sample size: planned number of clusters
200 subjects
Sample size: planned number of observations
1200 CO tests
Sample size (or number of clusters) by treatment arms
50 subjects per treatment arm per location
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
82% chance to detect a 20% treatment effect for a two-sample proportion t-test.
IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
IRB Approval Date
IRB Approval Number