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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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In the citing paper
“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
Experimental — accuracy not yet measuredIn the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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
In the citing paper
“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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Metadata
- 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 › Public Health, Environmental and Occupational Health › 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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