In this proposed study with People Living with HIV/AIDS (PLWHA), we will use a stepped care
model called a Sequential Multiple Assignment Randomized Trial (SMART) to examine the
efficacy of low- and high-intensity smoking cessation treatments for nicotine dependent PLWHA
that incorporate the current standard of care and prize-based contingency management.
Intervention will be administered in a community-based HIV integrated care clinic in downtown
Detroit, which has the highest prevalence rates of HIV/AIDS and smoking in Michigan. Phase 1
will last 4 weeks, and will involve brief intervention to help participants stop smoking. For
phase 2, participants will be assigned to different study arms depending on whether they are
Responders (reduced their smoking) or Non-responders (continued to smoke).
1. Phase 1: We hypothesize that brief high-magnitude prize contingency management will
result in greater reduction in smoking than standard of care alone.
2. Phase 2a: We hypothesize that non-responders who are assigned to contingency management
will be more likely to reduce their smoking throughout treatment and to abstain from
smoking at all follow-up points.
3. Phase 2b: We hypothesize that responders who are assigned to monitoring and
low-magnitude prize contingency management will be more likely to maintain their reduced
or abstinent smoking status at all follow-up time-points.