A Test of Motivational Plus Nicotine Replacement Interventions for HIV Positive Smokers

Abstract

The purpose of this study was to test two combination motivational plus pharmacological interventions for smoking cessation among HIV positive smokers. Participants were 40 adults receiving HIV care who smoked daily reporting interest in smoking reduction. Measures were administered at baseline, 1-month, and 3-month follow-ups. Participants were randomly assigned to self-guided reading plus nicotine patch (n = 18) or motivational interviewing plus nicotine patch (n = 22). Groups did not differ at 3 months on biochemically-verified abstinence. The sample reduced cigarettes per day by half a pack and the percent of smoking days by 41%, and 22% were abstinent at 3-month follow-up. Compliance with the nicotine patch was poor and declined over time, but patch use was unrelated to carbon monoxide level at 3-month follow-up. Smoking cessation interventions for people with HIV can be helpful and should include components that encourage some smoke-free days, increase self-efficacy, and attend to adherence to nicotine replacement treatment.

Smoking Cessation for People Living With HIV/AIDS: A Literature Review and Synthesis

“…Another trial comparing self-guided reading of smoking cessation materials (plus NRT) to motivational interviewing (single session plus NRT) revealed no significant group differences at 3-month follow-up. 36 One pilot study randomized PLWHA to either a combined 8-week NRT and SBIRT (Screening, Brief Intervention, and Referral for Treatment) counseling or a usual care condition which involved standard HIV medical care and no smoking cessation treatment (although participants in standard care did participate in smoking assessments on the same schedule as the SBIRT group). 37 SBIRT resulted in fewer self-reported cigarettes smoked per day, lower physical nicotine dependence, lower smoking urge, and lower nicotine withdrawal symptoms than participants in an assessment-only condition.…”

“…Further, a few smaller, uncontrolled, and open-label trials have shown smoking reduction among PLWHA using NRT and behavioral interventions. 11,36,40 Compliance with NRT tends to be poor across studies. 36,42 Further, it appears that psychological variables, including self-efficacy and motivation (decisional balance) around quitting, may mediate the relationship between NRT use and smoking abstinence.…”

“…11,36,40 Compliance with NRT tends to be poor across studies. 36,42 Further, it appears that psychological variables, including self-efficacy and motivation (decisional balance) around quitting, may mediate the relationship between NRT use and smoking abstinence. 55 Bupropion, a norepinephrine-dopamine reuptake inhibitor that is also used to treat depression, has similarly demonstrated efficacy across numerous smoking cessation trials in a number of different patient groups, 54 but no randomized trials have examined the efficacy of bupropion in PLWHA.…”

Comparison of mHealth and Face-to-Face Interventions for Smoking Cessation Among People Living With HIV: Meta-Analysis (Preprint)

“…We excluded 13 additional studies for the following reasons: the outcome was not abstinence (4 studies), no control group (4 studies), follow-up less than four weeks (1 study), quasi-experimental study (1 study), face-to-face or mHealth interventions were not specified (1 study), zero smoking abstinence rate in both intervention and control groups, yields a computational error (1 study), and participants in the intervention arm received either mHealth or face-to-face interventions but not both (1 study). Hence, 10 RCTs met the inclusion criteria and included in the analysis [20][21][22][23][24][25][26][27][28][29] .…”

“…Average age of the study population was 45 years (range: 42 to 50) and women comprised about 37% (range: 8% to 100%). Smoking cessation strategies were administered face-to-face in seven studies, [14][15][16][17][18]20,21 and sustained smoking abstinence estimates were reported in four studies. 14,[21][22][23] The intensity and maximum follow-up period ranged from 4 weeks to as much 52 weeks.…”