{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T16:34:22Z","timestamp":1786466062845,"version":"build-2736575974"},"reference-count":52,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n More than 70% of people experiencing homelessness report current smoking. Contingency management (CM) interventions that provide financial incentives for smoking cessation have shown short-term promise, but extended CM interventions have not been well studied in this population.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To assess the feasibility and preliminary efficacy of an extended 6-month CM intervention for smoking cessation among adults experiencing homelessness.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This pilot parallel 2-group randomized clinical trial was conducted in 3 safety-net clinics in San Francisco, California. Adults experiencing homelessness who smoked cigarettes and intended to quit within 6 months were enrolled from November 8, 2021, to June 27, 2023. Participants were followed up for 6 months, completed 24-week follow-up on January 9, 2024, and completed exploratory 52-week follow-up on May 21, 2024. Data were analyzed between June 1, 2024, and December 31, 2025.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Participants were randomized to extended CM or a control condition. The CM group received escalating gift card incentives for carbon monoxide (CO)\u2013verified abstinence, starting at $13 and increasing by $0.50 for each negative test result for 6 months. Control participants received $5 per visit regardless of abstinence.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The preliminary efficacy outcome was 7-day point prevalence abstinence (PPA; CO-verified self-report of abstinence). The secondary outcome was repeated 7-day PPA.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 83 participants, 42 were randomized to CM and 41 to a control. The mean (SD) age was 47.0 (10.8) years, and 53 participants (63.9%) were men. At 6 months, 7-day PPA was 31.0% in the CM group and 12.2% in the control group. After adjustment for covariates and with missing data treated as smoking, participants in the CM group had higher odds of achieving 7-day PPA at 6 months than those in the control group (adjusted odds ratio, 3.24 [95% CI, 1.03-10.19];\n P<\/jats:italic>\n \u2009=\u2009.04).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this pilot randomized clinical trial of adults experiencing homelessness, an extended CM intervention was feasible to implement and was associated with higher odds of 7-day PPA than the control condition. These findings suggest that extended CM may be a promising strategy for supporting smoking cessation in this population, but larger trials are needed to confirm efficacy.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT04982952<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.27917","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T15:30:18Z","timestamp":1786462218000},"page":"e2627917","source":"Crossref","is-referenced-by-count":0,"title":["Contingency Management for Smoking Cessation Among Adults Experiencing Homelessness"],"prefix":"10.1001","volume":"9","author":[{"given":"Dian","family":"Gu","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine, University of California, San Francisco"},{"name":"Center for Tobacco Control Research and Education, University of California, San 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