Discounting of delayed health gains and losses by current, never- and ex-smokers of cigarettes

Abstract

Recent evidence implicates steep discounting of delayed outcomes as an important feature of drug dependence. We determined discounting rates for health gains and health losses in current cigarette smokers (n = 23), neversmokers (n = 22) and ex-smokers (n = 21). Participants indicated preference for immediate vs. delayed hypothetical health gains and for immediate vs. delayed hypothetical health losses in a titration procedure that determined indifference points at a range of delays. The degree of discounting was estimated using two nonlinear decay models: an exponential model and a hyperbolic model. The hyperbolic equation generally provided better fits to the data than the exponential equation did. Current smokers discounted delayed health gains and health losses more steeply than never-smokers did. Discounting by ex-smokers was generally intermediate to that of current smokers and never-smokers, although not statistically different from either. Current smokers and ex-smokers discounted delayed health losses more steeply than they did health gains. Never-smokers did not discount gains and losses differently. Cigarette smokers show rapid loss of value for delayed health outcomes, emphasizing the need for smoking-cessation treatments that provide relatively immediate consequences for abstinence.