Evaluating partner-involved financial incentive treatments for smoking cessation in dual-smoker couples: A randomized controlled trial protocol

Background: Individuals who smoke combustible nicotine cigarettes and are partnered with another smoker are less likely to quit smoking than other smokers. Financial incentives for cessation increase individual abstinence. However, these interventions have not been examined using a dyadic approach that targets the couple rather than an individual. The current study will evaluate two variants of a dyadic financial incentive intervention for smoking cessation in dual-smoking couples. Methods: Feasibility and tolerability of dyadic financial incentive treatments in dual-smoking couples has been established, along with their preliminary efficacy. The current study will utilize a large-scale clinical trial to systematically evaluate the efficacy and mechanisms of change of two variants of dyadic financial incentive interventions among 450 dual-smoking couples. Results: The primary study outcome will be 6-month point-prevalence abstinence (self-report abstinence for 7 days + biochemical verification) among targets in dual-smoking couples. Partner abstinence at 6-months, and both target and partner abstinence at 1, 3, and 12 months will be examined as secondary outcomes. Potential treatment mechanisms, including motivational and relationship processes will be evaluated to inform future interventions. Discussion: Individuals with smoking partners experience low motivation to quit and low success rates when they make quit attempts. Current evidence-based interventions target individuals in isolation from their social networks that strongly influence them. This approach represents a critical next step toward developing interventions that effectively capitalize on social network members to produce and sustain smoking cessation.