Contingency Management Program Shows Promise for Supporting Smoking Cessation Among Veterans

CM provides concrete incentives in the form of canteen vouchers to reward days of not smoking. 

The program is having a powerful impact on motivation levels to quit. Program Manager Liz Naughton explained, "Adding this program has positively impacted the motivation for Veterans to quit smoking and commit to that while at the DOM. Before this program, the interest in smoking cessation was minimal but that has greatly improved given we can provide rewards instead of punishments."

Psychologist Dr. Dipali Patel shared, "I have heard Veterans feel more confident in their ability to quit for good after stringing together almost a month without smoking. Veterans who previously were less confident in quitting have voiced that they now feel more confident to abstain from smoking due to the program."

The program is also shifting perspectives on what constitutes "success" in quitting attempts. Dr. Patel added, "Veterans have voiced that this has been the longest they've abstained from smoking and that they are proud of it, rather than equating slips to complete failure."

Moreover, the program facilitates positive staff-Veteran interactions and aligns with the facility’s whole health approach. The ability to continue after a positive test reinforces that recovery is nonlinear. Beyond abstinence itself, CM also appears to be having secondary benefits for self-efficacy and relationships.

Case Manager Rosalie Bouchard-Bihr noticed, "Having the program available has allowed a shift in approaching quitting conversations. Instead of focusing on negatives, it can be framed as a positive goal with rewards. This approach has gotten veterans excited about quitting rather than dreading it."

In summary, CM seems to be a promising way to support smoking cessation for Veterans. This program was a collaboration between the Bedford VA Domiciliary Team, Philadelphia VA CESATE, and the national Tobacco Use Treatment office.