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Marchal-Mateos MI, López-Núñez C, Fernández-Artamendi S. Effectiveness of Contingency Management in Tobacco Smokers with Depressive Symptoms: A Systematic Review. Subst Use Misuse 2024; 59:792-804. [PMID: 38268117 DOI: 10.1080/10826084.2024.2302169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Background: Effective interventions are required to address tobacco smoking in people with depressive symptomatology. In this context, contingency management could be one useful therapeutic strategy. Objectives: This study is a systematic review of tobacco cessation interventions for smokers with depressive symptomatology including a contingency management component, evaluating their efficacy with regards to tobacco abstinence, depressive symptomatology, adherence to treatment and other variables related to tobacco use. For this purpose, a search was carried out in Pubmed, PsycINFO, Cochrane, Web of Science and ClinicalTrials.gov in September 2022. The quality of the studies was assessed using the Cochrane Risk of Bias tool. Results: Of the 208 articles identified, six were included in this review. Results: For the most part, the research included suggests that contingency management is an effective strategy for improving abstinence outcomes, adherence, and other smoking-related variables such as delay discounting and intensity of cigarette demand in smokers with depressive symptomatology. Conclusions: Although contingency management could be a promising intervention in tobacco smokers with depressive symptomatology, further research in this area is still required.
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Affiliation(s)
| | - Carla López-Núñez
- Department of Personality, Evaluation and Psychological Treatment, Universidad de Sevilla, Sevilla, Spain
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Webb A, Coward L, Yousef M, Karamesinis A, Leong S. Does offering small financial incentives to smokers at the time of being wait-listed for surgery increase smoking cessation by the day of surgery? A randomised feasibility trial. BMJ Open 2023; 13:e080693. [PMID: 38154905 PMCID: PMC10759110 DOI: 10.1136/bmjopen-2023-080693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 12/04/2023] [Indexed: 12/30/2023] Open
Abstract
OBJECTIVE This study aims to assess whether offering small financial incentives to smokers on elective surgery wait-lists is feasible and increases quitting before surgery. DESIGN Randomised controlled trial, prospective, double-blinded. SETTING Single-centre, Australian metropolitan public hospital. PARTICIPANTS 620 adult smokers (≥10 cigarettes per day) were randomised on being wait-listed for elective surgery and 404 underwent operations (28 January 2021-31 July 2022) at the hospital (65.2%) by trial's end. INTERVENTION Intervention participants were offered at wait-listing an $A70 supermarket voucher for verified abstinence on the day of surgery, provided they registered an intention to quit before surgery. Registrants intending to quit were also referred to Quitline. Neither intervention was offered to control participants (usual care). Smokers wait-listed from 17 May 2021 were offered an increased incentive of $A140. MAIN OUTCOME MEASURES Primary outcome, quitting at least 24 hours before surgery, verified by exhaled carbon monoxide testing. Feasibility outcomes were the proportion taking up offers, ease of patient contact and disputes about quit status. RESULTS Of 620 randomised participants (control 312, intervention 308), 404 had surgery at the hospital during the trial (control 214, intervention 190), which was lower than expected (for COVID-19 reasons). Offering $A70 resulted in 21.9% registering to quit, increasing to 32.6% with $A140. Telephone calls were the most effective means to gain registrations. The proportion of intervention group patients verified quit at least 24 hours before surgery was similar to controls (9.5% vs 8.9%, OR 1.1, 95% CI 0.5 to 2.2). Quitline contact was higher in the intervention group (13.2% vs 2.3%, OR 6.3, 95% CI 2.3 to 21.6). Disputes over test results did not occur, but 17.4% of intervention participants claiming quit failed verification. CONCLUSION A single offer of financial rewards for perioperative cessation was feasible, without achieving clinically important quit differences. TRIAL REGISTRATION NUMBER ACTRN12620000130965.
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Affiliation(s)
- Ashley Webb
- Department of Anaesthesia, Monash University Central and Eastern Clinical School, Melbourne, Victoria, Australia
- Department of Anaesthesia, Peninsula Health, Frankston, Victoria, Australia
| | - Lisa Coward
- Department of Anaesthesia, Peninsula Health, Frankston, Victoria, Australia
| | - Michael Yousef
- Department of Anaesthesia, Peninsula Health, Frankston, Victoria, Australia
| | | | - Samuel Leong
- Department of Anaesthesia, Monash University Central and Eastern Clinical School, Melbourne, Victoria, Australia
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Pericot-Valverde I, Yoon JH, Byrne KA, Heo M, Niu J, Litwin AH, Gaalema DE. Effects of short-term nicotine deprivation on delay discounting among young, experienced, exclusive ENDS users: An initial study. Exp Clin Psychopharmacol 2023; 31:724-732. [PMID: 36355684 PMCID: PMC10405670 DOI: 10.1037/pha0000612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Delay discounting describes how rapidly delayed rewards lose value as a function of delay and serves as one measure of impulsive decision-making. Nicotine deprivation among combustible cigarette smokers can increase delay discounting. We aimed to explore changes in discounting following nicotine deprivation among electronic nicotine delivery systems (ENDS) users. Thirty young adults (aged 18-24 years) that exclusively used ENDS participated in two laboratory sessions: one with vaping as usual and another after 16 hr of nicotine deprivation (biochemically assessed). At each session, participants completed a craving measure and three hypothetical delay discounting tasks presenting choices between small, immediate rewards and large, delayed ones (money-money; e-liquid-e-liquid; e-liquid-money). Craving for ENDS significantly increased during short-term nicotine deprivation relative to normal vaping. Delay discounting rates in the e-liquid now versus money later task increased (indicating a shift in preference for smaller, immediate rewards) following short-term nicotine deprivation relative to vaping as usual, but no changes were observed in the other two discounting tasks. Short-term nicotine deprivation increased the preference for smaller amounts of e-liquid delivered immediately over larger, monetary awards available after a delay in this first study of its kind. As similar preference shifts for drug now versus money later have been shown to be indicative of increased desire to use drug as well as relapse risk, the findings support the utility of the current model as a platform to explore interventions that can mitigate these preference shifts. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Irene Pericot-Valverde
- Department of Psychology, 418 Bracket Hall, Clemson University, Clemson, SC 29634, USA
- Prisma Health Addiction Research Center, 605 Grove Rd., Prisma Health, Greenville, SC 29605, USA
| | - Jin H. Yoon
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, 1941 East Road, University of Texas Health Science Center at Houston, Houston, TX 77054, USA
| | - Kaileigh A. Byrne
- Department of Psychology, 418 Bracket Hall, Clemson University, Clemson, SC 29634, USA
- Prisma Health Addiction Research Center, 605 Grove Rd., Prisma Health, Greenville, SC 29605, USA
| | - Moonseong Heo
- Prisma Health Addiction Research Center, 605 Grove Rd., Prisma Health, Greenville, SC 29605, USA
- Department of Public Health Sciences, 503 Edwards Hall, Clemson University, Clemson, SC 29631, USA
| | - Jiajing Niu
- Prisma Health Addiction Research Center, 605 Grove Rd., Prisma Health, Greenville, SC 29605, USA
- School of Mathematical and Statistical Science, Martin Hall, Clemson University, Clemson, SC 29634, USA
| | - Alain H. Litwin
- Prisma Health Addiction Research Center, 605 Grove Rd., Prisma Health, Greenville, SC 29605, USA
- Department of Medicine, USC School of Medicine Greenville, 607 Gove Rd, Greenville, SC 29605, USA
| | - Diann E. Gaalema
- Vermont Center on Behavior and Health, 1 South Prospect Street, University of Vermont, Burlington, VT 05401, USA
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Siersbaek R, Parker S, Kavanagh P, Ford JA, Burke S. How and why do financial incentives contribute to helping people stop smoking? A realist review protocol. BMJ Open 2022; 12:e060457. [PMID: 35705352 PMCID: PMC9204444 DOI: 10.1136/bmjopen-2021-060457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Smoking is harmful to human health and programmes to help people stop smoking are key public health efforts that improve individual and population health outcomes. Research shows that financial incentives improve the success of stop smoking programmes. However, a better understanding of how they work is needed to better inform policy and to support building capability for implementation.The aims of this study: (1) To review the international literature to understand: How, why, in what circumstances and for whom financial incentives improve the success of stop smoking interventions among general population groups and among pregnant women. (2) To provide recommendations for how to best use financial incentives in efforts to promote smoking cessation. METHODS AND ANALYSIS A realist review of published international literature will be undertaken to understand how, why, for whom and in which circumstances financial incentives contribute to success in stopping smoking for general population groups and among pregnant women. Systematic searches were undertaken on 16 February 2022 of five academic databases: MEDLINE (ovid), Embase.com, CIHAHL, Scopus and PsycINFO. Iterative searching using citation tracking and of grey literature will be undertaken as needed. Using Pawson and Tilley's iterative realist review approach, data collected will be screened, selected, coded, analysed and synthesised into a set of explanatory theoretical findings. ETHICS AND DISSEMINATION Ethical approval is not required for this review as data sources to be included are previously published. The study will provide important findings for policy-makers and health system leaders to guide the development of stop smoking services which use incentives, for example, as part of the Health Service Executive's Tobacco Free Programme in Ireland. Understanding how contextual factors impact implementation and programmatic success is key to developing a more effective public health approach to stop smoking. Our dissemination strategy will be developed with our stakeholders. PROSPERO REGISTRATION NUMBER CRD42022298941.
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Affiliation(s)
- Rikke Siersbaek
- Centre for Health Policy and Management, Trinity College Dublin School of Medicine, Dublin 2, Ireland
| | - Sarah Parker
- Centre for Health Policy and Management, Trinity College Dublin School of Medicine, Dublin 2, Ireland
| | - Paul Kavanagh
- National Health Intelligence Unit, Strategy and Research, Jervis House, Jervis St, Health Service Executive, Dublin 1, Ireland
- Department of Public Health and Epidemiology, Centre for Population Health and Health Services Research, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Sara Burke
- Centre for Health Policy and Management, Trinity College Dublin School of Medicine, Dublin 2, Ireland
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Downey H, Haynes JM, Johnson HM, Odum AL. Deprivation Has Inconsistent Effects on Delay Discounting: A Review. Front Behav Neurosci 2022; 16:787322. [PMID: 35221945 PMCID: PMC8867822 DOI: 10.3389/fnbeh.2022.787322] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/11/2022] [Indexed: 11/15/2022] Open
Abstract
Delay discounting, the tendency for outcomes to be devalued as they are more temporally remote, has implications as a target for behavioral interventions. Because of these implications, it is important to understand how different states individuals may face, such as deprivation, influence the degree of delay discounting. Both dual systems models and state-trait views of delay discounting assume that deprivation may result in steeper delay discounting. Despite early inconsistencies and mixed results, researchers have sometimes asserted that deprivation increases delay discounting, with few qualifications. The aim of this review was to determine what empirical effect, if any, deprivation has on delay discounting. We considered many kinds of deprivation, such as deprivation from sleep, drugs, and food in humans and non-human animals. For 23 studies, we analyzed the effect of deprivation on delay discounting by computing effect sizes for the difference between delay discounting in a control, or baseline, condition and delay discounting in a deprived state. We discuss these 23 studies and other relevant studies found in our search in a narrative review. Overall, we found mixed effects of deprivation on delay discounting. The effect may depend on what type of deprivation participants faced. Effect sizes for deprivation types ranged from small for sleep deprivation (Hedge's gs between −0.21 and 0.07) to large for opiate deprivation (Hedge's gs between 0.42 and 1.72). We discuss possible reasons why the effect of deprivation on delay discounting may depend on deprivation type, including the use of imagined manipulations and deprivation intensity. The inconsistency in results across studies, even when comparing within the same type of deprivation, indicates that more experiments are needed to reach a consensus on the effects of deprivation on delay discounting. A basic understanding of how states affect delay discounting may inform translational efforts.
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Affiliation(s)
- Haylee Downey
- Odum Laboratory, Department of Psychology, Utah State University, Logan, UT, United States
- Translational Biology Medicine and Health Graduate Program, Virginia Tech, Blacksburg, VA, United States
| | - Jeremy M. Haynes
- Odum Laboratory, Department of Psychology, Utah State University, Logan, UT, United States
| | - Hannah M. Johnson
- Odum Laboratory, Department of Psychology, Utah State University, Logan, UT, United States
| | - Amy L. Odum
- Odum Laboratory, Department of Psychology, Utah State University, Logan, UT, United States
- *Correspondence: Amy L. Odum
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Effects of episodic future thinking on reinforcement pathology during smoking cessation treatment among individuals with substance use disorders. Psychopharmacology (Berl) 2022; 239:631-642. [PMID: 35020047 PMCID: PMC8799566 DOI: 10.1007/s00213-021-06057-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 12/28/2021] [Indexed: 02/04/2023]
Abstract
RATIONALE Reinforcer pathology (RP) is a theoretical model based on two processes: delay discounting (DD) and drug demand. Given that RP has been shown to have a predictive value on smoking behaviors, several studies have explored which interventions can reduce RP. Consistent with the RP framework, episodic future thinking (EFT) has shown effects on treatment outcomes and RP processes. The vast majority of studies that assess the effects of EFT on RP consist of experimental studies, and no previous research has tested these effects in a clinical sample of smokers. OBJECTIVES The primary aim of this study was to assess the effects of EFT on RP throughout the course of a smoking cessation intervention in smokers with substance use disorders (SUDs). METHODS Participants were randomized to cognitive behavior therapy (CBT) + EFT (n = 39) or CBT + EFT + contingency management (n = 33). Cotinine, frequency of EFT practices, cigarette purchase task (CPT), and DD were evaluated in treatment sessions. Mixed-effects model repeated measures analysis was used to explore DD and CPT in-treatment changes as a function of EFT practices and cotinine levels. RESULTS Greater practice of the EFT component significantly reduced cigarette demand (p < .020) as well as DD (p = .003). Additionally, a greater reduction in cotinine levels coupled with greater EFT practice led to a greater decrease in cigarette demand (p < .014). CONCLUSIONS EFT reduced the two facets of RP in treatment-seeking smokers with SUDs.
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Aonso-Diego G, González-Roz A, Krotter A, García-Pérez A, Secades-Villa R. Contingency management for smoking cessation among individuals with substance use disorders: In-treatment and post-treatment effects. Addict Behav 2021; 119:106920. [PMID: 33798921 DOI: 10.1016/j.addbeh.2021.106920] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/18/2021] [Accepted: 03/18/2021] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Smokers with substance use disorders (SUDs) show elevated tobacco prevalence, and smoking abstinence rates are considerably low. This randomized controlled trial sought to compare the effect of a cognitive behavioral treatment (CBT) that includes an episodic future thinking (EFT) component with the same treatment protocol plus contingency management (CM). This study aims to examine the effect of CM on smoking outcomes and in-treatment behaviors (i.e., retention, session attendance and adherence to nicotine use reduction guidelines), and to analyze whether these in-treatment variables predicted days of continuous abstinence at end-of-treatment. METHOD A total of 54 treatment-seeking participants (75.9% males, M = 46.19 years old) were allocated to CBT + EFT (n = 30) or CBT + EFT + CM (n = 24). Intervention consisted of eight weeks of group-based sessions. Tobacco abstinence was verified biochemically by testing levels of carbon monoxide (≤4ppm) and urine cotinine (≤80 ng/ml). RESULTS CM intervention increased 24-hour tobacco abstinence (50% vs. 20%, χ2(1) = 5.4; p = .021) and days of continuous abstinence (M = 5.92 ± 7.67 vs. 5.53 ± 12.42; t(52) = -0.132; p = 0.89) at end-of-treatment in comparison with CBT + EFT intervention. Although not statistically significant, CBT + EFT + CM enhanced in-treatment behaviors, in terms of retention (83.3% vs. 70%; χ2(1) = 0.255; p = .208), sessions attended (12.29 ± 3.22 vs. 10.93 ± 3.26; t(52) = -1.527; p = .133) and adherence to weekly nicotine use reduction targets (41.07% ± 31.96 vs. 35% ±2 6.28; t(52) = -0.766; p = .447). A higher percentage of samples meeting reduction guidelines (β = 0.609; p<.001) predicted days of continuous abstinence at end-of-treatment. CONCLUSION Combining CM with CBT + EFT improves short-term quitting rates. Findings suggest the need to incorporate strategies for improving adherence to nicotine reduction guidelines.
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Sarwer DB, Wadden TA, Ashare RL, Spitzer JC, McCuen-Wurst C, LaGrotte C, Williams NN, Edwards M, Tewksbury C, Wu J, Tajeu G, Allison KC. Psychopathology, disordered eating, and impulsivity in patients seeking bariatric surgery. Surg Obes Relat Dis 2021; 17:516-524. [PMID: 33341423 PMCID: PMC8212387 DOI: 10.1016/j.soard.2020.11.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 10/30/2020] [Accepted: 11/04/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Most patients who undergo bariatric surgery experience significant weight loss and improvements in obesity-related co-morbidities in the first 6-18 months after surgery. However, 20%-30% of patients experience suboptimal weight loss or significant weight regain within the first few postoperative years. Psychosocial functioning may contribute to suboptimal weight loss and/or postoperative psychosocial distress. OBJECTIVE Assess psychosocial functioning, eating behavior, and impulsivity in patients seeking bariatric surgery. SETTING Two university hospitals. METHODS Validated interviews and questionnaires. Impulsivity assessed via computer program. RESULTS The present study included a larger (n = 300) and more racially diverse (70% non-White) sample than previous studies of these relationships. Forty-eight percent of participants had a current psychiatric diagnosis and 78% had at least 1 lifetime diagnosis. Anxiety disorders were the most common current diagnosis (25%); major depressive disorder was the most common lifetime diagnosis (44%). Approximately 6% of participants had a current alcohol or substance use disorder; 7% had a positive drug screen before surgery. A current psychiatric diagnosis was associated with greater symptoms of food addiction and night eating. Current diagnosis of alcohol use disorder or a lifetime diagnosis of anxiety disorders was associated with higher delay discounting. CONCLUSION The study identified high rates of psychopathology and related symptoms among a large, diverse sample of bariatric surgery candidates. Psychopathology was associated with symptoms of disordered eating and higher rates of delay discounting, suggesting impulse control issues.
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Affiliation(s)
- David B Sarwer
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania.
| | - Thomas A Wadden
- Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Rebecca L Ashare
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jacqueline C Spitzer
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Courtney McCuen-Wurst
- Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Caitlin LaGrotte
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Noel N Williams
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania
| | | | - Colleen Tewksbury
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania
| | - Jingwei Wu
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Gabriel Tajeu
- Department of Health Services Administration and Policy, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Kelly C Allison
- Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Czuczman C, Thompson M, Wileyto EP, Schnoll R, Metzger D, Leone F, Mounzer K, Gross R, Ashare RL. No differences in delay discounting between smokers with and without HIV. Psychopharmacology (Berl) 2021; 238:529-537. [PMID: 33180174 PMCID: PMC7855959 DOI: 10.1007/s00213-020-05701-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 10/30/2020] [Indexed: 10/23/2022]
Abstract
RATIONALE People with HIV (PWH) smoke cigarettes at much higher rates than the general population and evidence-based cessation methods are less effective, putting PWH at greater risk for negative health outcomes. It is critical to identify the factors that underlie this health disparity. Delay discounting-the decline in the value of a reward when it is delayed-may explain this disparity. OBJECTIVES This study aimed to (1) compare delay discounting between adult smokers with HIV and without HIV and (2) evaluate whether acute smoking abstinence disproportionately increases delay discounting among smokers with HIV. METHODS This sub-study was part of a larger study (NCT03169101) examining predictors of smoking cessation outcomes among smokers with HIV (n = 34) and smokers without HIV (n = 46) at two counterbalanced laboratory sessions (once smoking-as-usual and once following 24-h biochemically confirmed abstinence) then again, after 8 weeks of smoking cessation treatment. RESULTS There were no significant differences in delay discounting rates between HIV status groups (p = 0.49) or within-subject abstinence effects (p = 0.70). However, smokers without HIV exhibited a significant increase in delay discounting following smoking cessation treatment compared to baseline (p = 0.02), whereas the change among smokers with HIV did not reach statistical significance (p = 0.09). CONCLUSIONS These findings do not support differences in delay discounting as a reason for the lower success rates of HIV+ smokers at quitting. Although delay discounting may not explain the disparity in smoking rates between people with and without HIV, future work should focus on additional correlates of higher smoking rates and lower quit rates among people with HIV.
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Affiliation(s)
- Cory Czuczman
- Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite, Philadelphia, PA, 4100, USA
| | - Morgan Thompson
- Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite, Philadelphia, PA, 4100, USA
| | - E Paul Wileyto
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Robert Schnoll
- Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite, Philadelphia, PA, 4100, USA
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - David Metzger
- Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite, Philadelphia, PA, 4100, USA
| | - Frank Leone
- Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA, USA
| | - Karam Mounzer
- Philadelphia FIGHT, 1233 Locust St., Philadelphia, PA, USA
| | - Robert Gross
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca L Ashare
- Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite, Philadelphia, PA, 4100, USA.
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van den Brand FA, Candel MJJM, Nagelhout GE, Winkens B, van Schayck CP. How Financial Incentives Increase Smoking Cessation: A Two-Level Path Analysis. Nicotine Tob Res 2021; 23:99-106. [PMID: 31993637 PMCID: PMC7789935 DOI: 10.1093/ntr/ntaa024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 01/24/2020] [Indexed: 12/19/2022]
Abstract
Introduction Financial incentives effectively increase smoking cessation rates, but it is unclear via which psychological mechanisms incentives influence quit behavior. The current study examines how receiving financial incentives for smoking cessation leads to quitting smoking and investigates several mediators and moderators of that relationship. Aims and Methods The study sample consisted of 604 tobacco-smoking employees from 61 companies in the Netherlands who completed a baseline and follow-up questionnaire. The current study is a secondary analysis from a cluster randomized trial where employees received smoking cessation group counseling at the workplace. Participants in the intervention group additionally received financial incentives of €350 in total for 12-month continuous smoking abstinence. We used a two-level path analysis to test a model that assesses the effects of financial incentives through smoking cessation program evaluation, medication use, nicotine replacement use, attitudes, self-efficacy, and social influences on quit success. We additionally tested whether an individual’s reward responsiveness moderated the influence of incentives on quit success. Results The effect of financial incentives on quit success was mediated by a higher self-efficacy. Financial incentives were also associated with a higher use of cessation medication. A more positive program evaluation was related to higher self-efficacy, more social influence to quit, and more positive attitudes about quitting. The results did not differ significantly by individual reward responsiveness. Conclusions The results of the current study suggest that financial incentives may be used to increase medication use and self-efficacy for quitting smoking, which offers an indirect way to increase successful smoking cessation. Implications (1) This is the first study investigating via which psychological pathways financial incentives for quitting smoking can lead to long-term quit success. (2) The results showed a path between financial incentives and a higher likelihood of medication use. Incentives may encourage smokers to use medication in order to increase their chance of quitting smoking and receive the reward. (3) There was a path from financial incentives to quit success via a higher self-efficacy. (4) The effects of financial incentives did not depend on individual reward responsiveness.
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Affiliation(s)
- Floor A van den Brand
- Department of Family Medicine, Maastricht University (CAPHRI), Maastricht, The Netherlands
| | - Math J J M Candel
- Department of Methodology and Statistics, Maastricht University (CAPHRI), Maastricht, The Netherlands
| | - Gera E Nagelhout
- Department of Family Medicine, Maastricht University (CAPHRI), Maastricht, The Netherlands.,Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands.,IVO Research Institute, The Hague, The Netherlands
| | - Bjorn Winkens
- Department of Methodology and Statistics, Maastricht University (CAPHRI), Maastricht, The Netherlands
| | - Constant P van Schayck
- Department of Family Medicine, Maastricht University (CAPHRI), Maastricht, The Netherlands
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Croote DE, Lai B, Hu J, Baxter MG, Montagrin A, Schiller D. Delay discounting decisions are linked to temporal distance representations of world events across cultures. Sci Rep 2020; 10:12913. [PMID: 32737357 PMCID: PMC7395128 DOI: 10.1038/s41598-020-69700-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 07/15/2020] [Indexed: 12/04/2022] Open
Abstract
Delay discounting describes the phenomenon whereby the subjective value of a reward declines as the time until its receipt increases. Individuals differ in the subjective value that they assign to future rewards, yet, the components feeding into this appraisal of value remain unclear. We examined whether temporal psychological distance, i.e. the closeness one feels to the past and future, is one such component. English speakers in the USA and Mandarin speakers in China completed a delay discounting task and organized past and future world events on a canvas according to their representation of the event’s temporal position relative to themselves. Previous work has identified linguistic and cultural differences in time conception between these populations, thus, we hypothesized that this sample would display the variability necessary to probe whether temporal psychological distance plays a role in reward valuation. We found that English speakers employed horizontal, linear representations of world events, while Mandarin speakers used more two-dimensional, circular representations. Across cultures, individuals who represented the future as more distant discounted future rewards more strongly. Distance representations of past events, however, were associated with discounting behaviors selectively in Mandarin speakers. This suggests that temporal psychological distance plays a fundamental role in farsighted decision-making.
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Affiliation(s)
- Denise E Croote
- The Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Baojun Lai
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, Guangzhou, 510631, China
| | - Jingchu Hu
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, Guangzhou, 510631, China
| | - Mark G Baxter
- The Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Alison Montagrin
- The Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA. .,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
| | - Daniela Schiller
- The Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA. .,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
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12
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Paasche C, Weibel S, Wittmann M, Lalanne L. Time perception and impulsivity: A proposed relationship in addictive disorders. Neurosci Biobehav Rev 2019; 106:182-201. [DOI: 10.1016/j.neubiorev.2018.12.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 11/07/2018] [Accepted: 12/04/2018] [Indexed: 12/11/2022]
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13
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Notley C, Gentry S, Livingstone‐Banks J, Bauld L, Perera R, Hartmann‐Boyce J. Incentives for smoking cessation. Cochrane Database Syst Rev 2019; 7:CD004307. [PMID: 31313293 PMCID: PMC6635501 DOI: 10.1002/14651858.cd004307.pub6] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Financial incentives, monetary or vouchers, are widely used in an attempt to precipitate, reinforce and sustain behaviour change, including smoking cessation. They have been used in workplaces, in clinics and hospitals, and within community programmes. OBJECTIVES To determine the long-term effect of incentives and contingency management programmes for smoking cessation. SEARCH METHODS For this update, we searched the Cochrane Tobacco Addiction Group Specialised Register, clinicaltrials.gov, and the International Clinical Trials Registry Platform (ICTRP). The most recent searches were conducted in July 2018. SELECTION CRITERIA We considered only randomised controlled trials, allocating individuals, workplaces, groups within workplaces, or communities to smoking cessation incentive schemes or control conditions. We included studies in a mixed-population setting (e.g. community, work-, clinic- or institution-based), and also studies in pregnant smokers. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. The primary outcome measure in the mixed-population studies was abstinence from smoking at longest follow-up (at least six months from the start of the intervention). In the trials of pregnant women we used abstinence measured at the longest follow-up, and at least to the end of the pregnancy. Where available, we pooled outcome data using a Mantel-Haenzel random-effects model, with results reported as risk ratios (RRs) and 95% confidence intervals (CIs), using adjusted estimates for cluster-randomised trials. We analysed studies carried out in mixed populations separately from those carried out in pregnant populations. MAIN RESULTS Thirty-three mixed-population studies met our inclusion criteria, covering more than 21,600 participants; 16 of these are new to this version of the review. Studies were set in varying locations, including community settings, clinics or health centres, workplaces, and outpatient drug clinics. We judged eight studies to be at low risk of bias, and 10 to be at high risk of bias, with the rest at unclear risk. Twenty-four of the trials were run in the USA, two in Thailand and one in the Phillipines. The rest were European. Incentives offered included cash payments or vouchers for goods and groceries, offered directly or collected and redeemable online. The pooled RR for quitting with incentives at longest follow-up (six months or more) compared with controls was 1.49 (95% CI 1.28 to 1.73; 31 RCTs, adjusted N = 20,097; I2 = 33%). Results were not sensitive to the exclusion of six studies where an incentive for cessation was offered at long-term follow up (result excluding those studies: RR 1.40, 95% CI 1.16 to 1.69; 25 RCTs; adjusted N = 17,058; I2 = 36%), suggesting the impact of incentives continues for at least some time after incentives cease.Although not always clearly reported, the total financial amount of incentives varied considerably between trials, from zero (self-deposits), to a range of between USD 45 and USD 1185. There was no clear direction of effect between trials offering low or high total value of incentives, nor those encouraging redeemable self-deposits.We included 10 studies of 2571 pregnant women. We judged two studies to be at low risk of bias, one at high risk of bias, and seven at unclear risk. When pooled, the nine trials with usable data (eight conducted in the USA and one in the UK), delivered an RR at longest follow-up (up to 24 weeks post-partum) of 2.38 (95% CI 1.54 to 3.69; N = 2273; I2 = 41%), in favour of incentives. AUTHORS' CONCLUSIONS Overall there is high-certainty evidence that incentives improve smoking cessation rates at long-term follow-up in mixed population studies. The effectiveness of incentives appears to be sustained even when the last follow-up occurs after the withdrawal of incentives. There is also moderate-certainty evidence, limited by some concerns about risks of bias, that incentive schemes conducted among pregnant smokers improve smoking cessation rates, both at the end of pregnancy and post-partum. Current and future research might explore more precisely differences between trials offering low or high cash incentives and self-incentives (deposits), within a variety of smoking populations.
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Affiliation(s)
- Caitlin Notley
- University of East AngliaNorwich Medical SchoolNorwichUK
| | - Sarah Gentry
- University of East AngliaNorwich Medical SchoolNorwichUK
| | | | - Linda Bauld
- University of EdinburghUsher Institute, College of Medicine and Veterinary MedicineEdinburghUK
| | - Rafael Perera
- University of OxfordNuffield Department of Primary Care Health SciencesOxfordUK
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14
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Gowin J, Sloan ME, Swan JE, Momenan R, Ramchandani VA. The relationship between delay discounting and alcohol dependence in individuals with and without comorbid psychopathology. Psychopharmacology (Berl) 2019; 236:775-785. [PMID: 30456539 PMCID: PMC6401281 DOI: 10.1007/s00213-018-5113-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 11/05/2018] [Indexed: 01/12/2023]
Abstract
RATIONALE Alcohol use disorder (AUD) has been associated with greater discounting of delayed monetary rewards, but it is unclear whether this association is primarily related to alcohol consumption or is secondary to the presence of psychiatric comorbidities. It is also unclear if steeper rates of discounting are associated with greater AUD severity. OBJECTIVE We sought to determine whether the presence of comorbid psychiatric disorders affected the relationship between AUD and delay discounting. We also examined whether more severe AUD was associated with greater delay discounting. METHODS In this cross-sectional study, 793 adults completed a delay discounting task. Subjects were divided into four groups based on diagnosis: current AUD with psychiatric comorbidities (N = 226), current AUD without psychiatric comorbidities (N = 203), past AUD (N = 69), and healthy controls (N = 295). In those with AUD, we investigated the relationship between delay discounting and alcohol dependence symptom count and recent drinking history. We also compared individuals seeking treatment to non-treatment seeking individuals. Psychiatric comorbidities examined included mood disorders, anxiety disorders, and substance use disorders. RESULTS After adjusting for age, sex, income, and education, individuals with current AUD showed significantly higher rates of delay discounting than healthy controls and individuals with a past diagnosis of AUD. The presence of comorbid psychiatric diagnoses was not associated with steeper discounting. Among those with AUD, there was no evidence for a continuous relationship between delay discounting and AUD severity or alcohol consumption. Finally, non-treatment seekers with AUD had steeper delay discounting than treatment seekers. CONCLUSIONS Individuals with AUD show steeper delay discounting than healthy adults, but the effect is small and there is no added effect from comorbid psychopathology or increased AUD severity. This suggests that steeper delay discounting may have a more limited effect on human alcohol use than previously supposed.
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Affiliation(s)
- Joshua Gowin
- Department of Radiology, University of Colorado School of Medicine, Denver, CO, USA.
- Section on Human Psychopharmacology, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Building 10, Room 2-2352, Bethesda, MD, 20892-1540, USA.
| | - Matthew E Sloan
- Section on Human Psychopharmacology, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Building 10, Room 2-2352, Bethesda, MD, 20892-1540, USA
| | - Julia E Swan
- Section on Human Psychopharmacology, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Building 10, Room 2-2352, Bethesda, MD, 20892-1540, USA
| | - Reza Momenan
- Clinical NeuroImaging Research Core, Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Vijay A Ramchandani
- Section on Human Psychopharmacology, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Building 10, Room 2-2352, Bethesda, MD, 20892-1540, USA
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15
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Chen Z, Hu X, Chen Q, Feng T. Altered structural and functional brain network overall organization predict human intertemporal decision-making. Hum Brain Mapp 2019; 40:306-328. [PMID: 30240495 PMCID: PMC6865623 DOI: 10.1002/hbm.24374] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 08/14/2018] [Accepted: 08/15/2018] [Indexed: 11/06/2022] Open
Abstract
Intertemporal decision-making is naturally ubiquitous to us: individuals always make a decision with different consequences occurring at different moments. These choices are invariably involved in life-changing outcomes regarding marriage, education, fertility, long-term well-being, and even public policy. Previous studies have clearly uncovered the neurobiological mechanism of the intertemporal decision in the schemes of regional location or sub-network. However, it still remains unclear how to characterize intertemporal behavior with multimodal whole-brain network metrics to date. Here, we combined diffusion tensor image and resting-state functional connectivity MRI technology, in conjunction with graph-theoretical analysis, to explore the link between topological properties of integrated structural and functional whole-brain networks and intertemporal decision-making. Graph-theoretical analysis illustrated that the participants with steep discounting rates exhibited the decreased global topological organizations including small-world and rich-club regimes in both functional and structural connectivity networks, and reflected the dreadful local topological dynamics in the modularity of functional connectome. Furthermore, in the cross-modalities configuration, the same relationship was predominantly observed for the coupling of structural-functional connectivity as well. Above topological metrics are commonly indicative of the communication pattern of simultaneous global and local parallel information processing, and it thus reshapes our accounts on intertemporal decision-making from functional regional/sub-network scheme to multimodal brain overall organization.
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Affiliation(s)
- Zhiyi Chen
- Faculty of PsychologySouthwest UniversityChongqingChina
| | - Xingwang Hu
- Institute of EducationSichuan Normal UniversityChengduChina
| | - Qi Chen
- School of PsychologySouth China Normal UniversityGuangzhouChina
| | - Tingyong Feng
- Faculty of PsychologySouthwest UniversityChongqingChina
- Key Laboratory of Cognition and Personality, Ministry of EducationChongqingChina
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16
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Kuang J, Milhorn H, Stuppy-Sullivan A, Jung S, Yi R. Alternate versions of a fixed-choice, delay-discounting assessment for repeated-measures designs. Exp Clin Psychopharmacol 2018; 26:503-508. [PMID: 30035580 PMCID: PMC6162107 DOI: 10.1037/pha0000211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Delay discounting, reflected in the tendency to prefer immediate rewards over delayed rewards, is associated with most forms of problematic substance use. When assessed multiple times to examine within-individual changes, for example, following acute drug administration or an intervention, shifts in delay discounting simply because of repeated assessment is a concern, particularly when the assessment task is identical. This may be true for the Monetary Choice Questionnaire (MCQ), a widely used, fixed-item assessment of delay discounting. The present research examined possible within-individual difference/equivalence of MCQ indices at test/retest. This was contrasted with within-individual difference/equivalence when using an alternate version of the MCQ at retest, specifically developed to maintain the assessment structure and scoring of the original MCQ but with different choice items. Eighty-four participants completed delay discounting at test and retest with a 1-week interval; participants were randomized to complete the MCQ at both test and retest (MCQ/MCQ; n = 43) or complete the MCQ at test and an alternate version of the MCQ at retest (MCQ/MCQ-A; n = 41). Conventional hypothesis testing indicated no significant changes in delay discounting in the MCQ/MCQ condition or MCQ/MCQ-A condition. However, equivalence analysis, which is able to established whether scores are statistically equivalent, indicated that test/retest scores were not equivalent in some cases. Specifically, only 1 magnitude in the MCQ/MCQ condition was equivalent at test/retest, whereas 2 magnitudes in the MCQ/MCQ-A condition were equivalent at test/retest. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
- Jinyi Kuang
- University of Pennsylvania, 436 Cohen Hall, Philadelphia, PA 19104, 301-405-5862
| | - Hannah Milhorn
- University of Florida, P.O. Box 118210, Gainesville FL 32611, 352-294-1029
| | | | - Soyeon Jung
- University of Florida, P.O. Box 118210, Gainesville FL 32611, 352-294-1029
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17
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Bruijnzeel AW. Reward Processing and Smoking. Nicotine Tob Res 2017; 19:661-662. [PMID: 28486714 DOI: 10.1093/ntr/ntw303] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 11/07/2016] [Indexed: 12/20/2022]
Affiliation(s)
- Adriaan W Bruijnzeel
- Department of Psychiatry, University of Florida, Gainesville, FL.,Department of Neuroscience, University of Florida, Gainesville, FL
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