The Role of Contingency Management in Waterpipe Smoking Cessation

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DESCRIPTION (provided by applicant): Tobacco use kills more than 500,000 people in the United States each year. Although the use of cigarettes has declined, the use of other tobacco products has remained steady. Waterpipe smoking is a common form of tobacco smoking after cigarettes in the U.S. In fact, in 2007 the American Lung Association issued a policy alert to warn consumers about this first new tobacco trend of the 21st century. Few studies have been conducted on waterpipe smoking to investigate its harmful effects. Furthermore, no known studies have evaluated treatments for smoking cessation in waterpipe smokers. This project has two parts: 1) career development and training of a public health nurse scientist to build the research skills and background necessary to conduct innovative and rigorous research around waterpipe smoking prevention and 2) an analog study to test the role of contingency management (CM) in promoting abstinence from waterpipe smoking for 5 weeks verified by salivary cotinine and to characterize self-reported nicotine withdrawal symptoms. Based on the alarming growth rate over a short period of time in waterpipe tobacco smoking, there is a critical need for clinical research to investigate treatment modalities targeting smoking cessation for waterpipe smokers. Given the evidence for the role of CM in promoting abstinence from many types of drug use, investigation of the utility of CM for waterpipe smoking cessation is important and timely. Although Nicotine Replacement Therapy (NRT) is the mainstay treatment for treating nicotine dependence delivered through cigarettes, the intermittent use patterns that characterize waterpipe smoking suggest that CM may be more effective in promoting waterpipe smoking cessation. Ultimately, this line of research will help public health nurses to improve the health of the public through an innovative approach to treatment of waterpipe smoking and is an important and timely step towards meeting the tobacco objective for Healthy People 2020. To this end, the evidence based knowledge generated in this study may assist in the translation of the treatment program into public health practice.