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In the present study, our aim was to promote longer\u2010duration abstinence in this population. Following an initial 2\u2010week incentive intervention for smoking abstinence, we examined whether a 10\u2010week maintenance arm involving continuation of contingent reinforcement will produce greater smoking abstinence than a similar duration of noncontingent reinforcement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Randomized, 12\u2010week, parallel\u2010group study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Out\u2010patient research clinic in Burlington, Vermont, USA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Opioid\u2010maintained smokers (<jats:italic>n<\/jats:italic>= 88) who provided breath carbon monoxide and urinary cotinine specimens and received contingent reinforcement for smoking abstinence during weeks 1\u20132 (phase 1), with 63 randomized on day 14 to an extended contingent (EC;<jats:italic>n<\/jats:italic>= 31) or extended noncontingent (EN;<jats:italic>n<\/jats:italic>= 32) experimental condition for weeks 3\u201312 (phase 2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention and control<\/jats:title><jats:p>The EC condition consisted of voucher values that escalated across consecutive negative samples until they reached $30, after which they remained at $30 per negative sample. A positive or a missing sample resulted in no vouchers for that day and reset the value of the next negative same to $9. Two consecutive negatives returned the schedule to the pre\u2010reset value. The EN control condition consisted of vouchers delivered for providing scheduled samples, but independent of smoking status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>The primary outcome was percentage of biochemically abstinent samples during phase 2. Secondary measures included abstinence status at final study visit, complete abstinence, participants\u2019 longest duration of continuous abstinence, cotinine and carbon monoxide (CO) levels and self\u2010reported cigarettes per day.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>EC participants achieved greater smoking abstinence during phase 2 than EN participants [46.7 versus 23.5% negative samples, respectively; odds ratio (OR)\u00a0=\u00a02.98, 95% confidence interval (CI)\u00a0=\u00a01.16\u20137.65, \u03c7<jats:sup>2<\/jats:sup><jats:sub>1<\/jats:sub>\u00a0<jats:sup>=<\/jats:sup>\u00a05.0,<jats:italic>P\u00a0=<\/jats:italic>\u00a00.02]. When longest duration of continuous abstinence was compared between experimental groups, EC participants achieved twice the mean duration of continuous abstinence compared with EN participants (3.31 versus 1.68 weeks;<jats:italic>t<\/jats:italic><jats:sub>61<\/jats:sub>\u00a0=\u00a01.83,<jats:italic>P\u00a0=<\/jats:italic>\u00a00.07). An effect of experimental condition was also seen on mean cotinine levels (42.5 versus 210.6 ng\/ml, respectively;<jats:italic>F<\/jats:italic><jats:sub>1,61<\/jats:sub>=5.9,<jats:italic>P\u00a0=<\/jats:italic>\u00a00.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among opioid\u2010maintained smokers receiving an initial period of daily contingent incentives, a contingent reinforcement intervention appears to be more effective at extending smoking abstinence than noncontingent reinforcement over 10 weeks.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.13264","type":"journal-article","created":{"date-parts":[[2015,12,6]],"date-time":"2015-12-06T08:24:26Z","timestamp":1449390266000},"page":"903-912","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Financial incentives to promote extended smoking abstinence in opioid\u2010maintained patients: a randomized trial"],"prefix":"10.1111","volume":"111","author":[{"given":"Stacey C.","family":"Sigmon","sequence":"first","affiliation":[{"name":"Vermont Center on Behavior and Health Burlington VT USA"},{"name":"Departments of Psychiatry"},{"name":"Psychology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mollie E.","family":"Miller","sequence":"additional","affiliation":[{"name":"Vermont Center on Behavior and Health Burlington VT USA"},{"name":"Psychology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew C.","family":"Meyer","sequence":"additional","affiliation":[{"name":"Vermont Center on Behavior and Health Burlington VT USA"},{"name":"Departments of Psychiatry"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Saulsgiver","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine University of Pennsylvania Philadelphia PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary J.","family":"Badger","sequence":"additional","affiliation":[{"name":"Medical Biostatistics University of Vermont Burlington VT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah H.","family":"Heil","sequence":"additional","affiliation":[{"name":"Vermont Center on Behavior and Health Burlington VT USA"},{"name":"Departments of Psychiatry"},{"name":"Psychology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen T.","family":"Higgins","sequence":"additional","affiliation":[{"name":"Vermont Center on Behavior and Health Burlington VT USA"},{"name":"Departments of Psychiatry"},{"name":"Psychology"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,1,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200011023431802"},{"key":"e_1_2_7_3_1","article-title":"Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence","volume":"2","author":"Mattick R. 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