Perceived Detention Environment and Mental Health of Detainees in Immigration Detention Centers in Spain.

The increase in migratory flows worldwide has led to the creation of detention centers as a form of control of irregular migration. Recipient countries are responsible for protecting detainees' right to mental health, but the literature suggests that immigration detention centers are environments associated with complex mental health needs among the detainees. This study aims to approach the mental health of people detained in the immigration detention centers in Spain, a southern border of Europe. Eighty-seven migrants coming from different Latin American and African countries were interviewed using an adaptation of the Measure of Quality of Life in Detention (MQLD; Bosworth & Gerlach, 2020) to measure the perceived detention environment and The Hopkins Symptom Checklist-25 (HSCL-25; Derogatis et al., 1974) to assess mental health. The results show a high prevalence of detainees with significant levels of anxiety and depression (69%) and attempts at self-harm within the detention centers (19.5%). A more positive perception of the detention environment-especially concerning institutional decency and the relationship with officers-is related to a lower degree of negative mental health symptoms. Finally, people detained for more than 2 weeks assess the detention environment more negatively than those detained for less time. Scientific contributions and social implications to ensure the mental health of detainees from a human rights-based approach are discussed.

Effectiveness of Contingency Management in Tobacco Smokers with Depressive Symptoms: A Systematic Review.

Background: Effective interventions are required to address tobacco smoking in people with depressive symptomatology. In this context, contingency management could be one useful therapeutic strategy. Objectives: This study is a systematic review of tobacco cessation interventions for smokers with depressive symptomatology including a contingency management component, evaluating their efficacy with regards to tobacco abstinence, depressive symptomatology, adherence to treatment and other variables related to tobacco use. For this purpose, a search was carried out in Pubmed, PsycINFO, Cochrane, Web of Science and ClinicalTrials.gov in September 2022. The quality of the studies was assessed using the Cochrane Risk of Bias tool. Results: Of the 208 articles identified, six were included in this review. Results: For the most part, the research included suggests that contingency management is an effective strategy for improving abstinence outcomes, adherence, and other smoking-related variables such as delay discounting and intensity of cigarette demand in smokers with depressive symptomatology. Conclusions: Although contingency management could be a promising intervention in tobacco smokers with depressive symptomatology, further research in this area is still required.

Psychometric properties and factor structure of the brief Wisconsin Inventory of Smoking Dependence Motives among Spanish smokers from the general population.

INTRODUCTION: The brief version of the Wisconsin Inventory of Smoking Dependence Motives (B-WISDM) is a well-established instrument to measure the multidimensional nature of nicotine dependence. However, no previous research has assessed its psychometric properties in the Spanish context. The aim of the present study was to analyze the factor structure and measurement invariance across gender of this instrument among Spanish smokers from the general population. METHODS: This cross-sectional study assessed 480 smokers through an online questionnaire including information on tobacco use and several nicotine dependence measures. Confirmatory Factor Analysis was used to assess the factorial structure of the Spanish B-WISDM, its internal consistency, measurement invariance across gender and convergent validity with the Fagerström Test for Nicotine Dependence (FTND) and the Glover-Nilsson Smoking Behavioral Questionnaire (GN-SBQ) scores. RESULTS: Results indicate that the eleven correlated factors solution had a better fit when compared to the other tested models (two correlated factors and two second-order factors with eleven first-order correlated factors solution), remaining such structure invariant across gender. Internal consistency of the scale was high (α = 0.950; dimension α values ranged between 0.657 and 0.921). Overall scores and dimensions of the scale significantly and positively correlated with other nicotine dependence measures (except for Social/Environmental Goads and FTND). CONCLUSIONS: This is the first version of the B-WISDM validated to assess nicotine dependence with a multidimensional perspective within the Spanish culture. Results show adequate psychometric properties regarding its factor structure and measurement invariance across gender, supporting its utility to evaluate the motives driving tobacco use among Spanish smokers from the general population.

Evaluating the Effectiveness of a Psychological and Adventure-based Multicomponent Therapeutic Program for Victims of Intimate Partner Violence: A Pilot Study.

Intimate partner violence (IPV) is a global health problem with different negative consequences for women's mental health. This pilot study aims to evaluate the efficacy of a multicomponent intervention for battered women using a comparison group design to analyze improvement in self-esteem, self-concept, self-efficacy, body dissatisfaction, and depression. The intervention consisted of an eight-session multicomponent intervention program based on the combination of group psychological therapy and adventure activities. The study sample originally consisted of 34 women IPV victims. Self-report psychological assessment was conducted during the pre-test and post-test while interviews were conducted during the post-test among the experimental group. The results of this pilot study suggest the efficacy of the cognitive-behavioral multicomponent intervention on self-esteem, self-efficacy, and depression in the IPV victims from the experimental group. We conclude that these findings support the efficacy of this psychological intervention program. Practical implications and suggestions are also discussed.

Anxiety Sensitivity and Tobacco Use: A Transdiagnostic Approach / La sensibilidad a la ansiedad y el consumo de tabaco: un enfoque transdiagnóstico

Background: In recent years, several studies have found a relationship between transdiagnostic variables, such as anxiety sensitivity (AS) and tobacco use and smoking cessation. Method: In this line, the aim was twofold: 1) to analyze sex differences in variables related to tobacco and AS and 2) to examine the mediating effect of AS. For this purpose, the sample consisted of 340 smokers (Mage = 33.59 years, SD = 11.98, 68.5% women). Results: The results showed that men smoked more cigarettes per day and women had higher levels of total, physical, and cognitive AS. The structural equation model confirmed that AS is a mediator variable between the number of cigarettes per day and nicotine dependence, and the number of previous cessation attempts. Conclusions: These findings suggest that transdiagnostic variables, such as AS, and sex differences, must be taken into account in smoking cessation interventions. (AU)

Antecedentes: En los últimos años, diversos estudios han encontrado relación entre variables transdiagnósticas, como la sensibilidad a la ansiedad (SA) y el consumo de tabaco y dejar de fumar. Método: En esta línea, el objetivo ha sido doble: 1) analizar las diferencias de género en variables relacionadas con el tabaco y la SA y 2) examinar el efecto mediador de la SA. Para ello, la muestra consistió en 340 fumadores (Medad = 33.59 años, DT = 11.98, 68.5% mujeres). Resultados: Los resultados mostraron que los hombres fumaban más cigarrillos al día y las mujeres presentaban mayores niveles de SA total, física y cognitiva. El modelo de ecuaciones estructurales confirma que la SA es una variable mediadora entre el número de cigarrillos al día y la dependencia a la nicotina y el número de intentos previos de dejar de fumar. Conclusiones: Estos resultados sugieren que hay que tener en cuenta variables transdiagnósticas como la SA y las diferencias de género en las intervenciones para dejar de fumar. (AU)

Transdiagnostic model of psychological factors and sex differences in depression in a large sample of Ecuador

Background/Objective: Depression represents a leading cause of disability and a major contributor to the overall global burden of disease with women systematically reporting a higher prevalence than men. This study aimed to examine the predictive value and relation of three transdiagnostic psychological factors (perceived stress, psychological inflexibility and loneliness) on depression and its sex differences for the general population in a large sample of Ecuador.Method: A non-probabilistic and non-clinical sample of 16.074 people from across Ecuador were online surveyed using a cross-sectional design. The structural equation model was based on scores from standardized questionnaires as measures of depression, psychological perceived stress, psychological inflexibility, and loneliness.Results: Women reported significantly higher levels of depression, mediated by differences in perceived stress, psychological inflexibility and loneliness. Perceived stress was the most important predictor of depression and mediated the effect of loneliness on depression. Complementarily, psychological inflexibility partially mediated the effect of perceived stress and loneliness on depression. The overall model accounted for the 78% of the total variance in depression.Conclusions: Results of this study provide a novel and robust transdiagnostic model of sex differences on depression and insights on how to design effective programs for preventing depression targeting modifiable transdiagnostic risk factors. (AU)

Transdiagnostic model of psychological factors and sex differences in depression in a large sample of Ecuador.

Background/Objective: Depression represents a leading cause of disability and a major contributor to the overall global burden of disease with women systematically reporting a higher prevalence than men. This study aimed to examine the predictive value and relation of three transdiagnostic psychological factors (perceived stress, psychological inflexibility and loneliness) on depression and its sex differences for the general population in a large sample of Ecuador. Method: A non-probabilistic and non-clinical sample of 16.074 people from across Ecuador were online surveyed using a cross-sectional design. The structural equation model was based on scores from standardized questionnaires as measures of depression, psychological perceived stress, psychological inflexibility, and loneliness. Results: Women reported significantly higher levels of depression, mediated by differences in perceived stress, psychological inflexibility and loneliness. Perceived stress was the most important predictor of depression and mediated the effect of loneliness on depression. Complementarily, psychological inflexibility partially mediated the effect of perceived stress and loneliness on depression. The overall model accounted for the 78% of the total variance in depression. Conclusions: Results of this study provide a novel and robust transdiagnostic model of sex differences on depression and insights on how to design effective programs for preventing depression targeting modifiable transdiagnostic risk factors.

Psychometric Properties and Factor Structure of the Patient Health Questionnaire-9 as a Screening Tool for Depression Among Ecuadorian College Students.

Background: The Patient Health Questionnaire-9 (PHQ-9) is the most well-known self-report measure to screen for depressive symptomatology, although discerning which is the factor structure that represents the best fit remains a challenge. Objective: The aim of this study was to analyze the psychometric properties and factorial structure of the Spanish version of the PHQ-9 in a large sample of Ecuadorian college students. Methods: A total of 5,394 students (M = 22.03 years; SD = 3.05; 54.8% female) from three Ecuadorian universities were surveyed using a computerized questionnaire within a 4-week assessment period. The PHQ-9 was tested for factorial structure, reliability, and correlations with other mental health-related measures. Results: The hierarchical model that included a general factor and three nested factors had a better fit, and such a hierarchical structure remained invariant across sex and age. Total omega value (ω) was 0.90 for the total scale and hierarchical omega values (ωh) were 0.68 for the general factor, as well as 0.34, 0.38, and 0.44 for the respective nested factors (somatic, cognitive/affective, concentration/motor). Moreover, PHQ-9 scores were significantly higher among women, although effect sizes of comparison of those sex differences were very small. Finally, the PHQ-9 scores correlated with multiple mental health indicators (psychological inflexibility, loneliness, stress, and satisfaction with life). Discussion: The Spanish version of the PHQ-9 showed good psychometric properties among Ecuadorian college students. The hierarchical structure showed the best fit for the data, including not only a dominant general factor, but also the somatic, cognitive/affective and concentration/motor subcomponents. In conclusion, the PHQ-9 tool seems to represent an easy-to-implement screening questionnaire to design preventive programs for those Ecuadorian college students at risk of developing depressive disorders.

Prevention of Alcohol Consumption Programs for Children and Youth: A Narrative and Critical Review of Recent Publications.

Background: Youth substance use is a public health problem globally, where alcohol is one of the drugs most consumed by children, and youth prevention is the best intervention for drug abuse. Objective: Review the latest evidence of alcohol use prevention programs in empirical research, oriented to all fields of action among children and youth. Methods: A narrative and critical review was carried out within international databases (PsychInfo, Pubmed, Web of Science, and Scopus) in August 2021 and was limited to empirical studies that appeared in the last five years (2017-2021). A flow diagram was used according to the PRISMA statements. Empirical research articles in English with RCTs and quasi-experimental design that included alcohol, children, and young people up to 19 years of age (universal, selective, or indicated programs) were included. The authors examined the results and conceptual frameworks of the Prevention programs by fields of action. Results: Twenty-two articles were found from four fields of action: school (16), family (2), community (2), and web-based (2), representing 16 alcohol prevention programs. School-based alcohol prevention programs are clinically relevant [Theory of Planned Behavior, Refuse, Remove, Reasons, Preventure, The GOOD Life, Mantente REAL, Motivational Interviewing (BIMI), Primavera, Fresh Start, Bridges/Puentes], they are effective in increasing attitudes and intentions toward alcohol prevention behavior, while decreasing social norms and acceptance of alcohol, reducing intoxication, and increasing perceptions with regards to the negative consequences of drinking. Discussion: This narrative and critical review provides an updated synthesis of the evidence for prevention programs in the school, family, community, and web-based fields of action, where a more significant number of programs exist that are applied within schools and for which would have greater clinical relevance. However, the prevention programs utilized in the other fields of action require further investigation.

Gender Differences in Transdiagnostic Predictors of Problematic Alcohol Consumption in a Large Sample of College Students in Ecuador.

Background: Alcohol use is one of the main risk factors that leads to detrimental health effects and support for a transdiagnostic approach to alcohol use disorders is growing. However, the role of transdiagnostic predictors of problematic alcohol consumption in Ecuador are understudied. Objective: The aim of this study was to examine gender differences in psychological stress and inflexibility as transdiagnostic predictors of problematic alcohol consumption in a large sample of college students in Ecuador. Methods: A total of 7,905 college students (21.49 years, SD = 3.68; 53.75% females) were surveyed using the following standardized scales: Alcohol Use Disorders Identification Test, Perceived Stress Scale-14, and Acceptance and Action Questionnaire (AAQ-7). Macro Process for SPSS (models 4 and 7) was used to analyze mediation and moderation effects. Results: Reported alcohol consumption was significantly higher in men than women students. On the other hand, women reported significantly higher levels of perceived stress and psychological inflexibility than men students. Gender, age, psychological stress, and inflexibility were significant predictors of alcohol consumption. Moreover, psychological inflexibility mediated the impact of stress on alcohol consumption, particularly in women (for men b = 0.065, 95% CI [0.048 to 0.083], for women b = 0.070, 95% CI [0.051 to 0.089]). Discussion: Results of this study support psychological stress and psychological inflexibility as critical transdiagnostic variables related to increased rates of alcohol consumption among Ecuadorian college students. These conclusions contribute to the development of transdiagnostic comprehensive programs, which encompasses promotive, preventive, and treatment services that allow to alleviate the burden of alcohol, as well as to enrich the growing research on alcohol consumption in this population from a gender perspective.

The Role of Age of Onset in Problematic Alcohol Consumption: Artefact or Cohort Effect? / El papel de la edad de inicio en el consumo problemático de alcohol: ¿artefacto o efecto de cohorte?

Age of onset has been reported as a crucial predictor for alcohol consumption in adolescence. However, several authors have warned against it as an unreliable artefact accounted by the tendency to delay age of onset as respondents’ age increases (forward telescoping). This study aims to test whether age of onset is either a proxy for age or a predictor of alcohol consumption of its own. A hierarchical regression model and Process Macro for SPSS were used to test the effect of age of onset (controlling for age) on alcohol consumption and the mediating/moderator role of age of onset, parental control, and sex on alcohol consumption, respectively. Results support the role of age of onset as a significant predictor of alcohol consumption in Ecuadorian adolescents, rather than an artefact. Furthermore, age of onset completely mediated the effect of age on alcohol consumption, often moderated by sex. Practical implications are further discussed.

La edad de inicio se ha señalado como un predictor crucial del consumo de alcohol en la adolescencia. Sin embargo, varios autores han advertido que se trata de un artefacto poco fiable que se explica por la tendencia a retrasar la edad de inicio a medida que aumenta la edad de los encuestados (forward telescoping o sesgo de memoria). Este estudio pretende comprobar si la edad de inicio es una medida aproximativa de la edad o un predictor del consumo de alcohol por sí mismo. Se utilizó un modelo de regresión jerárquica y la Macro Process para SPSS para probar el efecto de la edad de inicio (controlando la edad) en el consumo de alcohol y el papel mediador/moderador de la edad de inicio, el control parental y el sexo en el consumo de alcohol, respectivamente. Los resultados confirman el papel de la edad de inicio como predictor significativo del consumo de alcohol en los adolescentes ecuatorianos en lugar de artefacto. Además, la edad de inicio medió completamente el efecto de la edad en el consumo de alcohol, con frecuencia moderado por el sexo. Se discuten posteriormente las implicaciones prácticas.

Analyzing the Behavior of Cannabis Users during the COVID-19 Confinement in Spain.

The impact of the COVID-19 pandemic on our lives is unquestionable, including in the area of substance consumption. This study aimed to evaluate the changes in the pattern of cannabis use during the Spanish COVID-19 lockdown and confinement, and to analyze the variations in the reported motives for cannabis use and withdrawal symptoms. A cross-sectional retrospective study was conducted between April and May 2020, using an instrument that included two time points. Time 1 collected retrospective information on the participants' habits (N = 89; 73% male; mean age = 29.01) prior to confinement and Time 2 collected the same information during the confinement. Sociodemographic data were collected, as well as the frequency of substance use, cannabis use patterns, sources of cannabis, perceived availability of drugs and cannabis price, and the Marijuana Motives Measure questionnaire and the Cannabis Withdrawal Scale were used. Results showed a decrease in both cannabis use and consumption due to enhancement and social motives. All reported sources of cannabis experienced a reduction except for the Internet, which experienced a significant increase. There was a positive correlation between withdrawal symptoms and coping motives before and during the lockdown. These findings will allow professionals to better develop both prevention and intervention strategies.

A Multicomponent Program to Improve Self-Concept and Self-Esteem among Intimate Partner Violence Victims: A Study Protocol for a Randomized Controlled Pilot Trial.

BACKGROUND: Intimate Partner Violence (IPV) is a major public health problem that affects one-third of women aged 15 around the world. Interventions for IPV victims are essential for women's self-esteem and self-concept recovery. This project aims to assess the effects of an eight-session multicomponent intervention program based on group psychological therapy and adventure activities in (1) self-esteem, (2) self-concept, (3) body image, (4) self-efficacy and (5) depression symptomatology in IPV victims. METHODS/DESIGN: A single-blind, randomized controlled pilot study, with experimental and control group, will be carried out. 34 IPV female victims will be recruited and equally assigned to the experimental (n = 17) or the control (n = 17) group. Primary outcome measures will include self-esteem, while secondary measures will be focused on self-concept, body image, self-efficacy, and depressive symptoms. Intention to treat and efficacy statistical analyses will be also performed. DISCUSSION: This project will explore the effects of a new multicomponent program which includes cognitive-behavioral therapy sessions and outdoor adventure activities on affective and emotional variables, often affected in IPV victims. In addition, orientations to incorporate the main findings into the community based IPV resources and victims' services will be provided.

Sex differences in comorbidity between substance use and mental health in adolescents two sides of the same coin / Diferencias de Sexo en Comorbilidad entre Consumo de Sustancias y Salud Mental en Adolescentes: Dos Caras de la Misma Moneda

BACKGROUND: This study aims to evaluate sex differences in alcohol and cannabis use and mental health disorders (MHD) in adolescents, and to evaluate the predictive role of mental health disorders for alcohol and cannabis use disorders (AUD and CUD respectively). METHOD: A sample of 863 adolescents from the general population (53.7% girls, Mage = 16.62, SD = 0.85) completed a computerized battery including questions on substance use frequency, the Brief Symptom Inventory, the Cannabis Problems Questionnaire for Adolescents - Short version, the Rutgers Alcohol Problem Index and the DSM-IV-TR criteria for AUD and CUD. Bivariate analyses and binary logistic regressions were performed. RESULTS: Girls presented significantly more mental health problems and a higher prevalence of comorbidity between SUD and MHD. Obsessive-compulsive symptoms and phobic anxiety indicated a higher risk of AUD, whereas depression and interaction between hostility and obsessive-compulsive disorder indicated a higher risk of CUD. CONCLUSIONS: Comorbidity between SUD and MHD is high among adolescents, and significantly higher among girls

ANTECEDENTES: el objetivo de esta investigación es evaluar las diferencias de sexo en el uso de cannabis y alcohol y en trastornos de salud mental TSM en adolescentes, y el rol predictivo de los TSM sobre los trastornos por uso de alcohol y cannabis (TUA y TUC, respectivamente). MÉTODO: una muestra de 863 adolescentes de la población general (53,7% chicas, edad media = 16.62, DT = 0,85) completaron una batería informatizada sobre la frecuencia de uso de sustancias, el Inventario Breve de Síntomas, el Cuestionario de Problemas por Consumo de Cannabis - versión breve, el Índice de Rutgers de Problemas con el Alcohol y los criterios DSM-IV-TR para el TUA y TUC. Se realizaron análisis bivariados y de regresión logística binaria. RESULTADOS: las chicas presentaron significativamente más problemas de salud mental y mayor prevalencia de comorbilidad entre TUS y TSM. El trastorno obsesivo-compulsivo (TOC) y la ansiedad fóbica indicaron un mayor riesgo de TUA, mientras que la depresión y la interacción entre hostilidad y TOC indicaron mayor riesgo de TUC. CONCLUSIONES: la comorbilidad entre TUS y TSM es alta entre los adolescentes, y significativamente mayor entre las chicas

Sex Differences in Comorbidity Between Substance Use and Mental Health in Adolescents: Two Sides of the Same Coin.

BACKGROUND: This study aims to evaluate sex differences in alcohol and cannabis use and mental health disorders (MHD) in adolescents, and to evaluate the predictive role of mental health disorders for alcohol and cannabis use disorders (AUD and CUD respectively). METHOD: A sample of 863 adolescents from the general population (53.7% girls, Mage = 16.62, SD = 0.85) completed a computerized battery including questions on substance use frequency, the Brief Symptom Inventory, the Cannabis Problems Questionnaire for Adolescents - Short version, the Rutgers Alcohol Problem Index and the DSM-IV-TR criteria for AUD and CUD. Bivariate analyses and binary logistic regressions were performed. RESULTS: Girls presented significantly more mental health problems and a higher prevalence of comorbidity between SUD and MHD. Obsessive-compulsive symptoms and phobic anxiety indicated a higher risk of AUD, whereas depression and interaction between hostility and obsessive-compulsive disorder indicated a higher risk of CUD. CONCLUSIONS: Comorbidity between SUD and MHD is high among adolescents, and significantly higher among girls.

Sensibilidad a la ansiedad como factor de vulnerabilidad transdiagnóstico para el consumo de tabaco: implicaciones clínicas y para el tratamiento / Anxiety sensitivity as a transdiagnostic vulnerability factor for cigarette smoking: Clinical and treatment implications

No disponible

Knowledge, Attitudes and Expectations of Physicians with Respect to Palliative Care in Ecuador: A Qualitative Study.

Background: The worldwide need for palliative care is high, especially in mid- income countries like Ecuador, where the percentage of patients receiving such care is very small due to the scarcity of infrastructure and specialized personnel and to the unequal distribution in the country. The objective of this study is to explore the knowledge, attitudes and expectations related to palliative care of the physicians in Ecuador. Methods: A qualitative study based on 28 semi-structured interviews, from March 2014 to November 2016, with physicians working in four cities in Ecuador recruited through the snowball technique. Thematic analysis was developed supported by the ATLAS.ti software. Results: Five core themes were identified: (1) training, (2) health policy, (3) professionals' activities, (4) health services and (5) development of palliative care in Ecuador. Conclusions: Strategies are needed which intensify the training of medical professional in palliative care, as well as avail the human resources and materials for providing it.

Systematic Review of Preventive Programs for Reducing Problem Gambling Behaviors Among Young Adults.

Young adulthood is a developmental period from late adolescence to one's late twenties or early thirties. Prevalence studies internationally have reported that individuals in this age group tend to have the highest rates of problem gambling. However, much of the prevention work designed to minimize the risk of problem and disordered gambling has been primarily focused on school settings and aimed at high school students. The objective of this study was to summarize the existing literature on the effectiveness of prevention programs aimed at reducing the prevalence of gambling problems in young adults. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six electronic academic databases were consulted in order to examine the studies conducted during the last 20 years. After removing duplicates and adhering to the inclusion and exclusion criteria, nine studies were included in this review. All studies targeted college or university students and followed a selective or indicated prevention strategy. A Personalized Normative Feedback approach was incorporated in most of the studies, which had generally good results in reducing and/or minimizing at-risk or problem gambling. The limited number of studies included in this review highlights the need to address scientific quality standards before proceeding with the design, implementation and widespread dissemination of these preventive programs as well as the need to ensure the program's efficacy prior to implementation.

A randomized controlled trial of contingency management for smoking abstinence versus contingency management for shaping cessation: One-year outcome.

This study analyzed whether a contingency management (CM) for shaping cessation period implemented prior to an abstinence-only period (CMS) improves outcomes relative to CM that reinforces only a fixed abstinence criteria (CMA) among treatment-seeking patients in a community setting. A total of 110 patients were randomly assigned to 1 of 2 treatment conditions: CMA (N = 55) or CMS (N = 55). All participants received cognitive-behavioral treatment (CBT) implemented in 6 group-based sessions. CMA participants earned voucher-based incentives contingent on providing biochemical evidence of smoking abstinence. CMS reinforced closer approximations to smoking abstinence. At posttreatment, patients assigned to the CMA group achieved the same rates of smoking abstinence (point-prevalence) as those in the CMS group (94.5%; p > .05). At the 6-month follow-up, 43.6% of the patients who received CMA maintained smoking abstinence in comparison to 32.7% in the CMS group (p > .05). At the 12-month follow-up, 40% of the participants assigned to the CMA group were abstinent, in comparison to 29.1% who received CMS (p > .05). There were no statistically significant differences in continuous smoking abstinence between the treatment conditions in any of the follow-ups (p > .05). These results offer a novel contribution by suggesting that CM was associated with enduring effects up to 12 months after the end of treatment and that CM for shaping cessation period implemented prior to an abstinence-only period (CMS) improves outcomes relative to CM that reinforces only a fixed abstinence criteria (CMA) among treatment-seeking patients in a community setting. (PsycINFO Database Record (c) 2019 APA, all rights reserved).