Examining Outcome Expectancies and Behavioral Reinforcers Among Young Adult Smokers


Chronic cigarette smoking habits often begin in adolescence or early adulthood. 98% of cigarette smokers try their first cigarette before the age of 26. Thus, young adult smokers represent an important target for early smoking cessation intervention. This study tests two interventions designed to increase motivation to quit and decrease smoking behavior. These interventions include: an expectancy challenge approach, which aims to increase negative beliefs about the consequences of smoking; and a behavioral economics approach, which encourages participants to substitute non-smoking behaviors that may still provide reinforcement similar to reinforcement derived from smoking a cigarette.

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: August 31, 2020


  • Behavioral: Expectancy Challenge
    • Expectancy challenge intervention (see description in study arms).
  • Behavioral: Expectancy Challenge + Behavioral Activation
    • Expectancy challenge + behavioral activation interventions (see description in study arms)
  • Behavioral: Control
    • Neutral reading condition (see description in study arms).

Arms, Groups and Cohorts

  • Active Comparator: Expectancy Challenge
    • The expectancy challenge intervention will involve two brief videotaped testimonials in which former smokers discuss their experiences with smoking-related health conditions. Participants will be encouraged to reflect back on the content of each video once per week leading up to the follow-up assessment.
  • Experimental: Expectancy Challenge + Behavioral Activation
    • In addition to the expectancy challenge intervention (see Expectancy Challenge condition), participants in the Expectancy Challenge + Behavioral Activation group will also receive a novel behavioral activation intervention. Participants will be presented with brief psychoeducation about behavioral activation, several examples of possible functions of cigarette smoking, and several suggestions of behavioral strategies. All participants will receive the same information, but they will be encouraged to apply the information to their personal circumstances and to consider additional examples of rewarding activities they may engage in over the next four weeks. Participants will also be encouraged to engage in at least one behavioral activation activity each week leading up to the follow-up assessment.
  • Placebo Comparator: Neutral Reading
    • The control group will receive neutral reading materials related to the components and structure of a cigarette. The content will be strictly curated so as to avoid inadvertently encouraging or discouraging smoking among participants.

Clinical Trial Outcome Measures

Primary Measures

  • Quit attempt
    • Time Frame: 4-week follow up
    • yes/no, whether or not the participant made a 24-hour (or longer) quit attempt between the date of the main experiment and the date of the 4-week follow-up assessment.
  • Motivation to quit
    • Time Frame: 4-week follow up
    • Contemplation ladder score (range 0-10; higher scores indicate more motivation to quit)

Secondary Measures

  • Smoking rate
    • Time Frame: 4-week follow up
    • past month average self-reported smoking rate
  • Outcome expectancies
    • Time Frame: 4-week follow up
    • Smoking Consequences Questionnaire (S-SCQ); expected positive and negative consequences of cigarette smoking (range 0-9; higher scores indicate greater positive or negative expectancies)
  • Behavioral reinforcers
    • Time Frame: 4-week follow up
    • Pleasant Events Schedule (PES); reported behaviors that are pleasurable and not associated with smoking/urge to smoke

Participating in This Clinical Trial

Inclusion Criteria

  • 18-30 years old
  • English fluency
  • Living in the United States
  • Smoked at least 1 cigarette per week during the past month
  • Willing to be contacted for 1-month follow up assessment

Exclusion Criteria

  • N/A

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 30 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • American University
  • Provider of Information About this Clinical Study
    • Principal Investigator: Amanda Kaufmann, Doctoral Candidate in Clinical Psychology – American University
  • Overall Contact(s)
    • Amanda Kaufmann, M.A., 203-722-6246, ak8129a@student.american.edu

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