Feasibility, Tolerability, and Potential Advantages of a Dyadic Financial Incentive Treatment for Smoking Cessation Among Dual-Smoker Couples: A Pilot Study

Public Health Significance This pilot study demonstrates the feasibility, tolerability, and potential advantages of implementing a dyadic financial incentive treatment for smoking cessation for people who smoke who are coupled with other smokers (dual-smoker couples). The majority of participants (86%) who were abstinent at 2-month follow-up were in a relationship with another smoker who was abstinent at follow-up, suggesting advantages of a dyadic financial incentive treatment to promote joint quit attempts among dual-smoker couples. As of 2019, 34.1 million adults in the United States smoke cigarettes. People who smoke and who are partnered with other smokers (i.e., dual-smoker couples [DSCs]) represent an estimated two-thirds of U.S. smokers. DSCs face unique obstacles to quitting, are less likely to try to quit, and are more likely to relapse during a quit attempt. Although joint quit attempts hold promise for DSCs' abstinence, few DSCs report trying to quit together. Financial incentive treatments [FITs]-where individuals receive monetary incentives for quitting and maintaining abstinence-increase motivation to quit, and so may help DSCs engage in joint quit attempts. We tested the feasibility and tolerability of adapting a financial incentive treatment to a dyadic context (N = 14 DSCs), in which both individuals of a smoking couple are offered incentives for attendance in a smoking cessation program ($100 USD) and abstinence at follow-up ($100 USD). Ten DSCs (71.4%) completed the follow-up session. Seven participants had biochemically verified abstinence at the follow-up session; of these, six of the seven (86%) were members of DSCs in which both partners were abstinent. Among participants who completed the follow-up session, cravings to smoke and tobacco withdrawal symptom severity were reduced over the study period. Participants rated the study as highly tolerable and listed many benefits and few costs from participation. The present study demonstrates the feasibility, tolerability, and potential advantages of implementing a dyadic financial incentive treatment for smoking cessation for DSCs in the U.S. over the course of 2 months.