# Measuring and modifying delay discounting as a mechanism of smoking in pregnancy

> **NIH NIH K08** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2024 · $184,824

## Abstract

PROJECT SUMMARY/ABSTRACT
One in 10 pregnant women in the United States smokes at the beginning of pregnancy, increasing the risk of
miscarriage, preterm birth, low birth weight, and neonatal death. Among these women who smoke, virtually all
report a desire to quit, yet only 25% abstain throughout pregnancy. A known behavioral economic mechanism
behind this “intention-action gap” is delay discounting (DD), the tendency to discount delayed outcomes
when choosing present actions. Because the negative consequences of smoking are delayed, whereas its
benefits are immediate, DD reinforces tobacco use even when one desires abstinence. In pregnancy, existing
smoking cessation pharmacotherapies are generally considered unsafe and/or ineffective, and thus DD may
provide a novel therapeutic target for smoking cessation treatment. However, three critical knowledge gaps
currently limit this possibility: (1) the optimal approach to measuring DD in the context of addiction is unclear,
(2) the longitudinal relationship between DD and smoking in pregnancy is poorly characterized, and (3) no
pharmacologic agent for reducing DD that is safe in pregnancy is known. To address these gaps, I will pursue
a set of training and research activities centered around “Measuring and Modifying Delay Discounting as a
Mechanism of Smoking in Pregnancy (The MM-DD Study)”. Leveraging (1) the Effort Delay Discounting Task
(EDDT), a novel mobile phone-based instrument that I have developed for measuring DD based on willingness
to exert cognitive and physical effort, (2) a mentorship committee with expertise in nicotine dependence,
behavioral economics, neuroscience, and structural equation modeling, and (3) an ongoing NIH-sponsored
RCT of high-dose omega-3 polyunsaturated fatty acid supplementation for pregnant smokers, my SPECIFIC
AIMS are to: (1) jointly measure and test the factor structure of cognitive effort DD, physical effort DD, and
monetary DD, (2) characterize the longitudinal relationship between DD and smoking in pregnancy, and (3)
safely test the modifiability of DD in pregnancy through a clinical trial. In parallel with these Aims, building on
previous training in behavioral economics, I will pursue four integrated training objectives, in which I will gain:
(1) advanced expertise in DD research, (2) foundational knowledge of the neurobiology of addiction, (3)
competence in structural equation modeling, and (4) skills to build scholarly productivity in biomedical
research. IMPACT: This career development award will (1) advance addiction science by systematically
measuring and attempting to modify DD as a novel therapeutic target for smoking cessation in pregnancy and
(2) advance my career by enabling me to secure R01 funding to further investigate novel approaches to
measuring and modifying DD across addiction contexts. In so doing, this award will position me to become an
independent investigator of interventions that prevent and treat addiction by targeting its behavio...

## Key facts

- **NIH application ID:** 10808430
- **Project number:** 1K08DA058046-01A1
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Scott Lee
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $184,824
- **Award type:** 1
- **Project period:** 2024-02-15 → 2027-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10808430

## Citation

> US National Institutes of Health, RePORTER application 10808430, Measuring and modifying delay discounting as a mechanism of smoking in pregnancy (1K08DA058046-01A1). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10808430. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*