title: Delay discounting rates: a strong prognostic indicator of smoking relapse.
abstract: BACKGROUND
  Recent evidence suggests that several dimensions of impulsivity and locus of control are likely to be significant prognostic indicators of relapse.
  
  
  METHODS
  One-hundred and thirty-one treatment seeking smokers were enrolled in six weeks of multi-component cognitive-behavioral therapy with eight weeks of nicotine replacement therapy.
  
  
  METHODS
  Cox proportional hazard regressions were used to model days to relapse with each of the following: delay discounting of $100, delay discounting of $1000, six subscales of the Barratt Impulsiveness Scale (BIS), Rotter's Locus of Control (RLOC), Fagerstrom's Test for Nicotine Dependence (FTND), and the Perceived Stress Scale (PSS). Hazard ratios for a one standard deviation increase were estimated with 95% confidence intervals for each explanatory variable. Likelihood ratios were used to examine the level of association with days to relapse for different combinations of the explanatory variables while accounting for nicotine dependence and stress level.
  
  
  RESULTS
  These analyses found that the $100 delay discounting rate had the strongest association with days to relapse. Further, when discounting rates were combined with the FTND and PSS, the associations remained significant. When the other measures were combined with the FTND and PSS, their associations with relapse non-significant.
  
  
  CONCLUSIONS
  These findings indicate that delay discounting is independently associated with relapse and adds to what is already accounted for by nicotine dependence and stress level. They also signify that delay discounting is a productive new target for enhancing treatment for tobacco dependence. Consequently, adding an intervention designed to decrease discounting rates to a comprehensive treatment for tobacco dependence has the potential to decrease relapse rates.
authors.affiliation: Department of Community Health and Social Medicine, Sophie Davis School of Biomedical Education, 160 Convent Ave, Harris Hall Suite 400, City College of New York, New York, NY 10031, USA; Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, USA; Department of Psychiatry, Center for Addiction Research, College of Medicine, 4301 West Markham St, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. Electronic address: csheffer@med.cuny.edu.
authors.forename: Christine E
authors.initials: CE
authors.lastname: Sheffer
authors.affiliation: Faculty of Health Sciences, University of Lethbridge, 4401 University Drive West, Lethbridge, AB T1K 3M4, Canada; Department of Psychiatry, Center for Addiction Research, College of Medicine, 4301 West Markham St, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
authors.forename: Darren R
authors.initials: DR
authors.lastname: Christensen
authors.affiliation: Department of Biostatistics, College of Medicine, 4301 West Markham St, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
authors.forename: Reid
authors.initials: R
authors.lastname: Landes
authors.affiliation: Department of Psychiatry, Center for Addiction Research, College of Medicine, 4301 West Markham St, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
authors.forename: Larry P
authors.initials: LP
authors.lastname: Carter
authors.affiliation: Department of Psychiatry, Center for Addiction Research, College of Medicine, 4301 West Markham St, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; Center for Clinical Translational Research, College of Medicine, 4301 West Markham St, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Jackson
authors.affiliation: Department of Psychiatry, Center for Addiction Research, College of Medicine, 4301 West Markham St, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; Center for Addiction Research, Virginia Tech Carilion Research Institute, 2 Riverside Circle, Roanoke, VA 24016, USA.
authors.forename: Warren K
authors.initials: WK
authors.lastname: Bickel
mesh_terms: D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D065786:Delay Discounting; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D011581:Psychological Tests; D012008:Recurrence; D012907:Smoking / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods; D000074606:Smoking Prevention; D061485:Tobacco Use Cessation Devices; D014029:Tobacco Use Disorder / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome
keywords: Delay discounting rates; Impulsivity; Smoking cessation; Tobacco dependence