for people ages 18 years and up (full criteria)
Healthy Volunteers
healthy people welcome
study started
completion around
Principal Investigator
by Maya Vijayaraghavan, MD, MAS (ucsf)
Headshot of Maya Vijayaraghavan
Maya Vijayaraghavan



The prevalence of smoking in the homeless population (70%) is over 4 times that of the general population (15%). Homeless adults have not experienced similar declines in tobacco use as the general population has over the past three decades. Homeless adults are interested in smoking cessation and make quit attempts, but are less successful in quitting smoking than the general population. Trials of group behavioral counseling and pharmacotherapy for smoking cessation have not led to substantial long-term abstinence (i.e., abstinence for 6 months or more), suggesting that these interventions alone are insufficient to improve quit rates among homeless adults. Many homeless adults seek health care in safety net clinics; these clinics could bring cessation interventions to scale. Contingency management is a powerful behavior change intervention that reinforces positive health behaviors through the provision of modest incentives (e.g., cash). In this pilot randomized controlled trial, the investigator will test the feasibility and acceptability of a contingency management intervention that provides incentives for smoking cessation for people experiencing homelessness.

Official Title

Randomized Trial of a Contingency Management Smoking Cessation Intervention for Homeless Adults


In this pilot randomized controlled trial (RCT), the investigator will (1) adapt a known-efficacious extended CM cessation intervention to a novel population and setting, with the ultimate goal of increasing long-term abstinence among homeless adults seeking care in safety net health clinics, (2) develop a corresponding RCT protocol, and (3) conduct a pilot RCT to assess the feasibility and acceptability of the RCT. If the pilot RCT is feasible and acceptable, the investigator will test the adapted intervention in a subsequently-funded, full-scale RCT.

Primary Objectives:

Assess feasibility and acceptability of a CM intervention through:

  1. Measuring biochemically-verified point prevalence abstinence at 6 months follow-up.
  2. Measuring participant adherence to the protocol.
  3. Gathering information on the number of visits attended.
  4. Assessing the retention protocol.

Secondary Objectives

Assess feasibility and acceptability of a CM intervention through:

  1. Biochemically-verified 7-day point months follow-up at 3 months.
  2. Prolonged abstinence at 3 months and 6 months follow-up.
  3. Point-prevalent abstinence at 12 months


Smoking Cessation, Smoking, Tobacco, Smoking Reduction, Contingency Management, Contingency Management - Increasing, Fixed payments, Contingency Management (CM)


You can join if…

Open to people ages 18 years and up

  1. Are 18 years or older
  2. Engaged in care at the Tom Waddell Urban Health Center (TWUHC)
  3. Meet criteria for homelessness as defined by the Homeless Emergency Assistance and Rapid Transition to Housing Act
  4. Are current smokers (smoked at least 100 cigarettes in lifetime, smoked daily in the past 7 days and at least 5 cigarettes per day, verified by expired Carbon Monoxide (CO) >= 8 parts per million (ppm))
  5. Have an intention to quit smoking within the next six months
  6. Are attending on-site smoking cessation counseling provided by the behavioral counselors
  7. Are English proficient
  8. Are able to provide informed consent. Patients who are interested in participating but not enrolled in counseling services will be encouraged to engage in counseling sessions at the time of enrollment.

You CAN'T join if...

  1. Are unable to take nicotine replacement therapy (e.g., pregnancy or myocardial infarction (MI) within the past 2 weeks)


  • University of California, San Francisco
    San Francisco California 94143 United States
  • The Richard H. Fine's People's Clinic
    San Francisco California 94110 United States

Lead Scientist at University of California Health

  • Maya Vijayaraghavan, MD, MAS (ucsf)
    Dr. Vijayaraghavan is a practicing general internist and a researcher in tobacco control with a focus on populations experiencing homelessness. She is the Director of the UCSF Smoking Cessation Leadership Center, a Center focused on eliminating disparities in tobacco use prevalence among behavioral health populations.


in progress, not accepting new patients
Start Date
Completion Date
University of California, San Francisco
Study Type
About 83 people participating
Last Updated