title: Discounting of delayed health gains and losses by current, never- and ex-smokers of cigarettes.
abstract: Recent evidence implicates steep discounting of delayed outcomes as an important feature of drug dependence. We determined discounting rates for health gains and health losses in current cigarette smokers (n = 23), never-smokers (n = 22) and ex-smokers (n = 21). Participants indicated preference for immediate vs. delayed hypothetical health gains and for immediate vs. delayed hypothetical health losses in a titration procedure that determined indifference points at a range of delays. The degree of discounting was estimated using two nonlinear decay models: an exponential model and a hyperbolic model. The hyperbolic equation generally provided better fits to the data than the exponential equation did. Current smokers discounted delayed health gains and health losses more steeply than never-smokers did. Discounting by ex-smokers was generally intermediate to that of current smokers and never-smokers, although not statistically different from either. Current smokers and ex-smokers discounted delayed health losses more steeply than they did health gains. Never-smokers did not discount gains and losses differently. Cigarette smokers show rapid loss of value for delayed health outcomes, emphasizing the need for smoking-cessation treatments that provide relatively immediate consequences for abstinence.
authors.affiliation: Department of Psychiatry, University of New Hampshire, Conant Hall, 10 Library Way, Durham, NH 03824-3567, USA. AOdum@hopper.unh.edu
authors.forename: Amy L
authors.initials: AL
authors.lastname: Odum
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Madden
authors.forename: Warren K
authors.initials: WK
authors.lastname: Bickel
mesh_terms: D000328:Adult; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D012907:Smoking; D016540:Smoking Cessation; D013997:Time Factors