Partner-Involved Financial Incentives for Smoking Cessation in Dual-Smoker Couples: A Randomized Pilot Trial.

INTRODUCTION: Members of dual-smoker couples (in which both partners smoke) are unlikely to try to quit smoking and are likely to relapse if they do make an attempt. The purpose of this study was to investigate the feasibility, tolerability, and preliminary outcomes of dyadic adaptations of financial incentive treatments (FITs) to promote smoking cessation in dual-smoker couples. AIMS AND METHODS: We enrolled 95 dual-smoker couples (N = 190) in a three-arm feasibility RCT comparing two partner-involved FITs (single vs. dual incentives) against a no-treatment control condition. Participants in all conditions were offered nicotine replacement and psychoeducation. A 3-month follow-up provided information about retention, tolerability (ie, self-reported benefits and costs of the study), and preliminary efficacy (ie, program completion, quit attempts, point-prevalent abstinence, and joint quitting). RESULTS: Results suggest dyadic adaptations were feasible to implement (89% retention rate) and highly tolerable for participants (p < .001). Neither feasibility nor tolerability varied across the treatment arm. Preliminary efficacy outcomes indicated partner-involved FITs have promise for increasing smoking cessation in dual-smoker couples (OR = 2.36-13.06). CONCLUSIONS: Dyadic implementations of FITs are feasible to implement and tolerable to participants. IMPLICATIONS: The evidence that dyadic adaptations of FITs were feasible and tolerable, and the positive preliminary efficacy outcomes suggest that adequately powered RCTs formally evaluating the efficacy of dyadic adaptations of FITs for dual-smoker couples are warranted.

COVID-19 stressors and health behaviors: A multilevel longitudinal study across 86 countries.

Anxiety associated with the COVID-19 pandemic and home confinement has been associated with adverse health behaviors, such as unhealthy eating, smoking, and drinking. However, most studies have been limited by regional sampling, which precludes the examination of behavioral consequences associated with the pandemic at a global level. Further, few studies operationalized pandemic-related stressors to enable the investigation of the impact of different types of stressors on health outcomes. This study examined the association between perceived risk of COVID-19 infection and economic burden of COVID-19 with health-promoting and health-damaging behaviors using data from the PsyCorona Study: an international, longitudinal online study of psychological and behavioral correlates of COVID-19. Analyses utilized data from 7,402 participants from 86 countries across three waves of assessment between May 16 and June 13, 2020. Participants completed self-report measures of COVID-19 infection risk, COVID-19-related economic burden, physical exercise, diet quality, cigarette smoking, sleep quality, and binge drinking. Multilevel structural equation modeling analyses showed that across three time points, perceived economic burden was associated with reduced diet quality and sleep quality, as well as increased smoking. Diet quality and sleep quality were lowest among respondents who perceived high COVID-19 infection risk combined with high economic burden. Neither binge drinking nor exercise were associated with perceived COVID-19 infection risk, economic burden, or their interaction. Findings point to the value of developing interventions to address COVID-related stressors, which have an impact on health behaviors that, in turn, may influence vulnerability to COVID-19 and other health outcomes.

Feasibility, tolerability, and potential advantages of a dyadic financial incentive treatment for smoking cessation among dual-smoker couples: A pilot study.

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. 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. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Energy Balance-Related Behavior Risk Pattern and Its Correlates During COVID-19 Related Home Confinement.

Self-reported weight gain during the COVID-19 shelter-at-home has raised concerns for weight increases as the pandemic continues. We aimed to investigate the relationship of psychological and health markers with energy balance-related behaviors during the pandemic-related extended home confinement. Ratings for stress, boredom, cravings, sleep, self-control, and beliefs about weight control were collected from 1,609 adults using a questionnaire between April 24th-May 4th, 2020, while COVID-19 associated shelter-in-place guidelines were instituted across the US. We calculated four energy balance behavior scores (physical activity risk index, unhealthy eating risk index, healthy eating risk index, sedentary behavior index), and conducted a latent profile analysis of the risk factors. We examined psychological and health correlates of these risk patterns. Boredom, cravings for sweet/savory foods, and high sleepiness ratings related to high risk of increasing unhealthy eating and sedentary behavior and decreasing physical activity and healthy eating. Having greater self-control, control over cravings, or positive mood was related to lowering all aspects of energy intake and energy expenditure risks. Although individuals in risk pattern classes showed similarity in physical activity and healthy/unhealthy eating habits, they exhibited different patterns of positive mood, craving control, food cravings, boredom, and self-control. Psychological and health variables may have a significant role to play in risk behaviors associated with weight gain during the COVID-19 related home confinement. Emerging behavioral patterns may be meaningful in developing targeted weight management interventions during the current pandemic.

Assessing multiple features of partner support for smoking cessation in dual-smoker couples.

The purpose of this study was to evaluate a new scale to measure multiple aspects of partner support for quitting smoking relevant to dual-smoker couples, called the Partner Support for Quitting Scale. The best model fit (N = 238 individuals in 119 couples) considers the frequency of, confidence in, and perceived usefulness of partner support behaviors. Path analysis revealed that the Partner Support for Quitting Scale factors were uniquely predicted by relationship commitment and nicotine dependence and, in turn, predicted self-efficacy for smoking cessation and desire to quit. Preliminary support was found for the Partner Support for Quitting Scales' value as an assessment tool for measuring partner support for smoking cessation among dual-smoker couples.