Delayed reward discounting predicts treatment response for heavy drinkers receiving smoking cessation treatment
Open accessAbstract
Delayed reward discounting (DRD) is a behavioral economic index of impulsivity that reflects the extent to which an individual devalues a reward based on its delay in time (i.e., preference for smaller immediate rewards relative to larger delayed rewards). Current smokers exhibit greater DRD compared to non-smokers, but also exhibit greater DRD compared to ex-smokers, suggesting that either DRD is inversely associated with successful smoking cessation or that smoking cessation itself reduces DRD. In a sample of treatment-seeking smokers (n=57, 61% male, 85% Caucasian) participating in a randomized controlled smoking cessation trial, the current study prospectively examined DRD for money in general and at three magnitudes in relation to time to the participants' first lapse to smoking. Survival analysis using Cox proportional-hazards regression revealed that DRD predicted days to first lapse (ps<.05-.01) and did so beyond nicotine dependence, sensation-seeking, and income in covariate analyses, with the exception of small magnitude discounting. In addition, dichotomous comparisons revealed significantly more impulsive baseline discounting for individuals who had lapsed by the two-week and eight-week follow-up visits. These findings indicate that high levels of DRD reflect a risk factor for poor smoking cessation treatment response. Interrelationships among the variables assessed and clinical strategies to improve outcomes for smokers who are high in DRD are discussed.
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Discounting rates are predictive of treatment outcomes.
“discounting rates are predictive of treatment outcomes [11, 62, 63, 70, 71].”
From The behavioral economics and neuroeconomics of reinforcer pathologies: implications for etiology and treatment of addiction (2011) · cites this paper as [62]
Low rates of discounting predict higher rates of success in substance abuse treatment programs.
“low rates of discounting predict higher rates of success in substance abuse treatment programs [62, 63]”
From The behavioral economics and neuroeconomics of reinforcer pathologies: implications for etiology and treatment of addiction (2011) · cites this paper as [62]
Excessive discounting among smokers predicts poorer response in smoking cessation treatment.
“poorer response in smoking cessation treatment [62]”
From The behavioral economics and neuroeconomics of reinforcer pathologies: implications for etiology and treatment of addiction (2011) · cites this paper as [62]
Longitudinal studies indicate that steep delay discounting precedes and predicts human drug use, lower rates of drug abstinence, and greater relapse during treatment.
“Longitudinal studies suggest that steep delay discounting precedes and predicts human drug use”
From Changing Delay Discounting and Impulsive Choice: Implications for Addictions, Prevention, and Human Health (2019) · cites this paper as MacKillop & Kahler, 2009
Individuals with lower rates of delay discounting tend to be more responsive to treatment for nicotine dependence or cocaine dependence.
“individuals with lower rates of delay discounting tend to be more responsive to treatment for nicotine dependence (Krishnan-Sarin et al., 2007; MacKillop & Kahler, 2009; Yoon et al., 2007), or cocaine dependence (Washio et al., 2011).”
From Excessive discounting of delayed reinforcers as a trans-disease process contributing to addiction and other disease-related vulnerabilities: Emerging evidence (2012) · cites this paper as MacKillop & Kahler, 2009
Delay discounting predicts poorer treatment response and higher likelihood of relapse when attempting to quit smoking.
“In addition to smoking initiation, when attempting to quit smoking, delay discounting predicts poorer treatment response162,163 and higher likelihood of relapse.163”
From Early life adversity and health-risk behaviors: Proposed psychological and neural mechanisms (2018) · cites this paper as [162]
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A MECHANISM FOR REDUCING DELAY DISCOUNTING BY ALTERING TEMPORAL ATTENTION
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Kale, D., Stautz, K., & Cooper, A. (2018) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2018.01.003 · Cited by 96 · see citing works
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Impulsivity-like traits and smoking behavior in college students
Spillane, N. S., Smith, G. T., & Kahler, C. (2010) · Addictive Behaviours · doi:10.1016/j.addbeh.2010.03.008 · Cited by 104 · see citing works
Self-citationClinical models of decision making in addiction
Koffarnus, M. N., & Kaplan, B. A. (2017) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2017.08.010 · Cited by 99 · see citing works
Courtney, K. E., Arellano, R., Barkley‐Levenson, E. E., Galván, A., Poldrack, R. A., MacKillop, J., Jentsch, J. D., & Ray, L. A. (2011) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2011.01635.x · Cited by 96 · see citing works
Self-citationA Machine-Learning Approach to Predicting Smoking Cessation Treatment Outcomes
Coughlin, L. N., Tegge, A. N., Sheffer, C. E., & Bickel, W. K. (2018) · Nicotine & Tobacco Research · doi:10.1093/ntr/nty259 · Cited by 96 · see citing works
Stojek, M. M., & MacKillop, J. M. (2017) · Clinical Psychology Review · doi:10.1016/j.cpr.2017.04.007 · Cited by 93 · see citing works
Self-citationMaintained Physical Activity Induced Changes in Delay Discounting
Sofis, M. J., Carrillo, A., & Jarmolowicz, D. P. (2016) · Behavior Modification · doi:10.1177/0145445516685047 · Cited by 92 · see citing works
Neuromodulation of delay discounting, the reflection effect, and cigarette consumption
Sheffer, C. E., Mennemeier, M., Landes, R. D., Bickel, W. K., Brackman, S. L., Dornhoffer, J. L., Kimbrell, T. A., & Brown, G. J. (2013) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2013.01.012 · Cited by 89 · see citing works
The role of impulsivity in relapse vulnerability
Pattij, T., & Vries, T. J. D. (2013) · Current Opinion in Neurobiology · doi:10.1016/j.conb.2013.01.023 · Cited by 88 · see citing works
Behavioral Economic Analysis of Cue-Elicited Craving for Tobacco: A Virtual Reality Study
Acker, J. D., & MacKillop, J. M. (2013) · Nicotine & Tobacco Research · doi:10.1093/ntr/nts341 · Cited by 88 · see citing works
Self-citationA Competing Neurobehavioral Decision Systems model of SES-related health and behavioral disparities
Bickel, W. K., Moody, L., Quisenberry, A. J., Ramey, C. T., & Sheffer, C. E. (2014) · Preventive Medicine · doi:10.1016/j.ypmed.2014.06.032 · Cited by 88 · see citing works
Neuroanatomical foundations of delayed reward discounting decision making
Owens, M. M., Gray, J. C., Amlung, M. T., Oshri, A., Sweet, L. H., & MacKillop, J. M. (2017) · NeuroImage · doi:10.1016/j.neuroimage.2017.08.045 · Cited by 85 · see citing works
Self-citationFriedel, J. E., DeHart, W. B., Madden, G. J., & Odum, A. L. (2014) · Psychopharmacology · doi:10.1007/s00213-014-3597-z · Cited by 86 · see citing works
Bickel, W. K., Quisenberry, A. J., Moody, L., & Wilson, A. G. (2015) · Clinical Psychological Science · doi:10.1177/2167702614541260 · Cited by 84 · see citing works
Cannabidiol as a Novel Candidate Alcohol Use Disorder Pharmacotherapy: A Systematic Review
Turna, J., Syan, S. K., Frey, B. N., Rush, B. R., Costello, M. J., Weiss, M., & MacKillop, J. M. (2019) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.13964 · Cited by 83 · see citing works
Self-citationRecovery from addiction: Behavioral economics and value-based decision making.
Field, M., Heather, N., Murphy, J. G., Stafford, T., Tucker, J. A., & Witkiewitz, K. A. (2019) · Psychology of Addictive Behaviors · doi:10.1037/adb0000518 · Cited by 76 · see citing works
Delay and Probability Discounting in Humans: An Overview
McKerchar, T. L., & Renda, C. R. (2012) · The Psychological Record · doi:10.1007/bf03395837 · Cited by 78 · see citing works
Mechanisms of impulsive choice: I. Individual differences in interval timing and reward processing
Marshall, A. T., Smith, A. P., & Kirkpatrick, K. (2014) · Journal of the Experimental Analysis of Behavior · doi:10.1002/jeab.88 · Cited by 75 · see citing works
Amlung, M. T., Sweet, L. H., Acker, J. D., Brown, C. L., & MacKillop, J. M. (2012) · Addiction Biology · doi:10.1111/adb.12017 · Cited by 76 · see citing works
Self-citationSheffer, C. E., Bickel, W. K., Brandon, T. H., Franck, C. T., Deen, D., Panissidi, L., Abdali, S. A., Pittman, J. C., Lunden, S. E., Prashad, N., et al. (2017) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2017.09.037 · Cited by 70 · see citing works
Temporal and Probability Discounting by Cigarette Smokers Following Acute Smoking Abstinence
Yi, R., & Landes, R. D. (2012) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntr252 · Cited by 72 · see citing works
Stevens, L., Goudriaan, A. E., Verdejo‐García, A., Dom, G., Roeyers, H., & Vanderplasschen, W. (2015) · Psychological Medicine · doi:10.1017/s003329171500001x · Cited by 70 · see citing works
MacKillop, J., Amlung, M. T., Wier, L. M., David, S. P., Ray, L. A., Bickel, W. K., & Sweet, L. H. (2012) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2011.10.003 · Cited by 70 · see citing works
Self-citationDelay discounting, impulsiveness, and addiction severity in opioid-dependent patients
Robles, E., Huang, B. E., Simpson, P. M., & Mcmillan, D. (2011) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2011.05.003 · Cited by 70 · see citing works
Bickel, W. K., Jones, B. A., Landes, R. D., Christensen, D. R., Jackson, L., & Mancino, M. (2010) · Experimental and Clinical Psychopharmacology · doi:10.1037/a0021739 · Cited by 66 · see citing works
Rung, J. M., Peck, S., Hinnenkamp, J. E., Preston, E., & Madden, G. J. (2019) · Perspectives on Behavior Science · doi:10.1007/s40614-019-00200-7 · Cited by 65 · see citing works
Dysregulated resting state functional connectivity and obesity: A systematic review
Syan, S. K., McIntyre-Wood, C., Minuzzi, L., Hall, G., McCabe, R. E., & MacKillop, J. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.08.019 · Cited by 66 · see citing works
Self-citationCampanella, S., Cimochowska, A., Kornreich, C., Hanak, C., Verbanck, P., & Petit, G. (2014) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s61475 · Cited by 66 · see citing works
Stautz, K., Zupan, Z., Field, M., & Marteau, T. M. (2018) · Health Psychology Review · doi:10.1080/17437199.2017.1421477 · Cited by 64 · see citing works
Delay Discounting and Preference Reversals by Cigarette Smokers
Yi, R., Matusiewicz, A. K., & Tyson, A. (2016) · The Psychological Record · doi:10.1007/s40732-016-0165-4 · Cited by 63 · see citing works
Ballard, M. E., Mandelkern, M. A., Monterosso, J. R., Hsu, E., Robertson, C. L., Ishibashi, K., Dean, A. C., & London, E. D. (2015) · The International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyu119 · Cited by 62 · see citing works
Moody, L. N., Franck, C. T., & Bickel, W. K. (2016) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2016.01.009 · Cited by 60 · see citing works
On the functional form of temporal discounting: An optimized adaptive test
Cavagnaro, D. R., Aranovich, G. J., McClure, S. M., Pitt, M. A., & Myung, J. I. (2016) · Journal of Risk and Uncertainty · doi:10.1007/s11166-016-9242-y · Cited by 60 · see citing works
Ultra-violet indoor tanning addiction: A reinforcer pathology interpretation
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Clarifying the relationship between impulsive delay discounting and nicotine dependence.
Amlung, M., & MacKillop, J. (2014) · Psychology of Addictive Behaviors · doi:10.1037/a0036726 · Cited by 55 · see citing works
Self-citationDelay discounting in adults receiving treatment for marijuana dependence.
Peters, E. N., Petry, N. M., LaPaglia, D. M., Reynolds, B. A., & Carroll, K. M. (2012) · Experimental and Clinical Psychopharmacology · doi:10.1037/a0030943 · Cited by 55 · see citing works
Gray, J. C., & MacKillop, J. M. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.01104 · Cited by 53 · see citing works
Self-citationStojek, M. M., Fischer, S. F., Murphy, C. M., & MacKillop, J. (2014) · Appetite · doi:10.1016/j.appet.2014.05.004 · Cited by 52 · see citing works
Self-citationTest–retest reliability and construct validity of the Experiential Discounting Task.
Smits, R. R., Stein, J. S., Johnson, P. S., Odum, A. L., & Madden, G. J. (2013) · Experimental and Clinical Psychopharmacology · doi:10.1037/a0031725 · Cited by 52 · see citing works
Schüller, C. B., Kuhn, J., Jessen, F., & Hu, X. (2019) · The American Journal of Drug and Alcohol Abuse · doi:10.1080/00952990.2018.1557675 · Cited by 52 · see citing works
A developmental perspective on neuroeconomic mechanisms of contingency management.
Stanger, C., Budney, A. J., & Bickel, W. K. (2013) · Psychology of Addictive Behaviors · doi:10.1037/a0028748 · Cited by 50 · see citing works
Joos, L., Goudriaan, A. E., Schmaal, L., Fransén, E., van den Brink, W., Sabbe, B., & Dom, G. (2012) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2012.10.004 · Cited by 50 · see citing works
Neural substrates of impulsive decision making modulated by modafinil in alcohol-dependent patients
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Increased impulsivity in rats as a result of repeated cycles of alcohol intoxication and abstinence
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Neuroeconomics: Implications for Understanding and Treating Addictive Behavior
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Biphasic effects of alcohol on delay and probability discounting.
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Self-citationDecreased delay discounting in former cigarette smokers at one year after treatment
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Will delay discounting predict intention to quit smoking?
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Delay Discounting in Impulsive Behavior
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Delay Discounting and Drug Abuse: Empirical, Conceptual, and Methodological Considerations
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Quantifying Reinforcement Value and Demand for Psychoactive Substances in Humans
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Self-citationEffects of measurement methods on the relationship between smoking and delay reward discounting
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- Authors
- MacKillop, J., & Kahler, C. W.
- Affiliations
- University of Georgia (US)
- Brown University (US)
- Corresponding author
- MacKillop, James
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2009-10
- Volume
- 104
- Issue
- 3
- Pages
- 197-203
- ISSN
- 0376-8716 (ISSN-L)
- PMC
- PMC2740648
- OpenAlex
- W2099419458
- Cited by
- 232
- References
- 61
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 3 · 2023: 10 · 2022: 8 · 2021: 13 · 2020: 8 · 2019: 22 · 2018: 12 · 2017: 19 · 2016: 18 · 2015: 18 · 2014: 36 · 2013: 13 · 2012: 21
- FWCI
- 9.75
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (K23AA016936)
- National Institute on Drug Abuse (R01DA015534, R01 DA15534)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Decision Sciences › General Decision Sciences › Decision-Making and Behavioral Economics
- Keywords
- delay discounting, impulsivity, smoking cessation, heavy drinkers, treatment response, smoking relapse, nicotine dependence, sensation seeking, behavioral economics, treatment-seeking smokers
- MeSH terms
- Adult, Alcohol Drinking, Counseling, Female, Humans, Male, Models, Psychological, Nicotine, Reward, Risk-Taking, Smoking, Tobacco Use Disorder, Smoking Cessation, Treatment Outcome
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