General Principles of Contingency Management for Smoking Cessation

Contingency management (CM) is a psychological treatment based on operant conditioning. It consists of providing incentives in exchange for achieving a target behaviour such as abstinence or other treatmentrelated variables (e.g. session attendance, adherence to medication). The objective of this article was to introduce the rationale of CM for substance use and, more specifically, for smoking cessation. A growing body of empirical literature supports CM as an effective treatment for quitting smoking both in the general population and among other hard-to-treat smokers (e.g. pregnant women or substance users). Despite this, CM remains the treatment least implemented in clinical settings, fundamentally because of its perceived costs in terms of both economic and non-economic resources. In this review article we describe the general principles of CM, the most recent evidence of its effectiveness for achieving tobacco abstinence, the specific characteristics of tobacco use assessment, and the limitations relative to its implementation, as well as possible solutions to these challenges.