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35th AM (2025) - Poster Session
Adapting Mobile CM to Support Smoking Cessation Am ...
Adapting Mobile CM to Support Smoking Cessation Among Veterans in VA Lung Cancer Screening and Cancer Care
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Pdf Summary
This qualitative study explored adapting mobile Contingency Management (CM) to support smoking cessation among Veterans undergoing lung cancer screening (LCS) or cancer care within the Veteran Affairs (VA) system. Smoking during LCS or cancer treatment is linked to worse health outcomes, including reduced treatment effectiveness and higher recurrence rates. Despite these risks, many Veterans in these care settings continue smoking, and cessation rates remain low.<br /><br />CM, which provides monetary rewards for bioverified abstinence, has been effective for substance use disorders in VA settings but has not been tested specifically for smoking cessation among Veterans receiving cancer-related care. The study aimed to assess barriers and facilitators to implementing a mobile CM program tailored to this population.<br /><br />Fifteen Veterans participated in semi-structured individual and group interviews to discuss challenges with quitting and to provide feedback on a proposed 5-week mobile CM intervention. Analysis revealed key barriers: Veterans often anticipate failure based on past quit attempts, many are in social environments where smoking is common, and they view smoking as a comforting habit. Additional barriers include limited familiarity with relevant technology, difficulty confirming abstinence remotely, and variability in monetary motivation.<br /><br />Facilitators identified include the use of VA-secure web applications familiar to many Veterans, provision of tech training and support, daily bioverification via portable carbon monoxide monitors with video evidence reviewed prior to incentives, and the motivational impact of monetary rewards complemented by weekly therapist check-ins and access to medications and behavioral treatments.<br /><br />Veterans reported that CM’s monetary incentives were highly motivating and offered a novel, positive engagement approach. The study highlights the need to tailor behavioral interventions for Veterans in high-risk groups to improve cessation success and overall health outcomes.<br /><br />Next steps involve incorporating these findings and Veteran feedback to pilot test a mobile CM intervention for Veteran smokers receiving lung cancer screening or cancer treatment, aiming to reduce smoking-related health disparities in this vulnerable population.
Keywords
mobile Contingency Management
smoking cessation
Veterans
lung cancer screening
Veteran Affairs system
bioverified abstinence
monetary incentives
behavioral interventions
carbon monoxide monitors
cancer treatment
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