Remotely delivered episodic future thinking and contingency management for smoking cessation: A randomized feasibility trial among military veterans in the United States

Cigarette smoking is a leading cause of death and disease in the United States and a significant concern for U.S. military veterans, who use tobacco at higher rates than nonveterans. Veterans face multiple obstacles to achieving long-term abstinence from smoking and might benefit from remotely delivered, novel approaches to smoking cessation treatment. This study employed reinforcer pathology theory to design a novel, accessible treatment approach that combined episodic future thinking with contingency management (EFT + CM) in a remotely delivered treatment for military veterans. Veterans (n = 97) participated in a 16-week, randomized control, single-blind, remotely delivered, feasibility study. The treatment phase was conducted from Week 1 to 12 with EFT delivered from Week 1 to 12 and CM delivered from Week 1 to 4. All participants received 12 weeks of nicotine patches. Feasibility measures included demand, adherence, practicality, acceptability, and limited efficacy testing. Across conditions, all feasibility measures were within acceptable ranges. The study enrolled 88% of eligible participants, and about two thirds completed the final outcome assessment. Adherence to submitting daily breath samples and to reviewing daily cues was over 80% and was acceptable across conditions. Relative to baseline, delay discounting rates decreased in the EFT + CM condition showing large effect sizes across time and small effect sizes in the control condition. The EFT + CM condition also showed a higher proportion of breath samples that reflected abstinence than those in the control condition. In conclusion, multiple indicators of feasibility suggest that a remotely delivered EFT + CM combined with nicotine patches is feasible and warrants further investigation. (PsycInfo Database Record (c) 2026 APA, all rights reserved).