Association for Behavior Analysis International

Substance abuse is a major public health crisis that is costly both in terms of health care expenditures and the resulting poor health outcomes for individuals and their families. In the current symposium, a series of talks will address different behavioral economic approaches to assessing and treating health behavior related to substance abuse. Strategies that will be presented include 1) the use low-risk behavioral economic assessments to predict treatment outcomes among pregnant women undergoing smoking-cessation treatment, 2) improving effective contraceptive use among opioid-maintained women of reproductive age using financial incentives, 3) assessing whether electronic cigarettes are viable behavioral substitutes to cigarettes, and 4) the use of a soft-commitment approach to reducing cigarette use. All presentations highlight the use of established principles of behavioral economics to address serious health concerns.

Board certified behavior analysts; licensed psychologists; graduate students.

Cigarette smoking is overrepresented among economically disadvantaged women, and smoking during pregnancy is the leading cause of poor pregnancy outcomes in the U.S. Two common low-risk experimental arrangements used in the study of cigarette smoking among pregnant women are the Cigarette Purchase Task (CPT) and delay discounting (DD). Few studies have evaluated whether combining CPT and DD may enhance understanding of smoking beyond observations with either alone. The current investigation evaluated the interrelationship between CPT and DD performance of pregnant women by examining associations with the likelihood of making antepartum quit attempts, a strong predictor of response to formal smoking-cessation treatment. Data from 114 women enrolled in an ongoing smoking-cessation clinical trial were analyzed. Intensity, Omax, and breakpoint were significantly and inversely associated with antepartum quit attempts. DD by itself was not significantly associated with antepartum quit attempts nor was it associated with the CPT indices. Considering the predictive CPT indices and DD together revealed a conditional relationship wherein associations between DD and quit attempts were conditional on Intensity and Omax level. That is, among those with relatively high demand Intensity or Omax DD was not associated with quit attempts, while among those with relatively low demand Intensity or Omax steep discounting was associated with a lower proportion of quit attempts. These results suggest that the influence of DD among pregnant smokers is mostly limited to lighter smokers or, said differently, heavy smoking appears to override any influence of DD on quitting smoking during pregnancy.