HIV Care Initiation: A Teachable Moment for Smoking Cessation?

Abstract

This study documents significant increases in intention to quit smoking in the 3-month period following HIV care initiation. Moreover, quit intention trended downward following the 3-month follow-up until the 12-month follow-up. In addition, a marked effect for HIV disease stage was observed, whereby participants with advanced HIV disease (vs. those without) experienced a greater increase in intention to quit. HIV treatment initiation appears to be associated with increases in intention to quit smoking, thus serves as a crucial teachable moment for smoking cessation intervention for people living with HIV.

Bone fracture among people living with HIV: A systematic review and meta-regression of prevalence, incidence, and risk factors

“…Wu et al [40] reported that smokers had twice the risk of fracture compared to non-smokers. Smoking cessation programs among smokers with HIV may reduce fracture risk after just three months [41]. The HCV co-infection risk, with pooled aHR of 1.6, confirms the findings of Dong et al's meta-analytic study.…”

The association between lifetime polytobacco use and intention to quit among HIV-positive cigarette smokers

“…Furthermore, this secondary analysis supports and builds upon our previous findings suggesting that disease status impacts smoking behaviors (Vidrine et al, 2017). Variables known to modulate the relationship between disease status and smoking behaviors, such as symptom burden and nicotine dependence, may underlie this relationship.…”

“…In fact, intention to quit smoking may increase upon the onset of HIV or an advancement in disease progression. Our previous work (Vidrine et al, 2017) observed increased intention to quit and abstinence among HIV-positive cigarette smokers with advanced disease stage, in comparison to those with no advanced HIV, at three and six-month post-diagnosis follow-ups. This research suggests that events/stages of HIV may serve as a teachable moment, defined as an event that can prompt individuals to adopt risk-reducing behaviors.…”

“…This research suggests that events/stages of HIV may serve as a teachable moment, defined as an event that can prompt individuals to adopt risk-reducing behaviors. Cessation interventions tailored to the teachable moment model may promote successful cessation among PLWH (Vidrine et al, 2017).…”

Systematic identification and referral of smokers attending HIV ambulatory care highlights the failure of current service provision in an at-risk population

“…These include the provision of very brief advice (VBA) by healthcare workers (a brief structured intervention consisting of assessing smoking behaviours and providing advice and specific recommendations to support smoking cessation), nicotine replacement therapy, prescription of bupropion or varenicline and use of stop smoking clinics 10. To date, few studies have assessed these interventions in the context of HIV care services and none have done so in the UK 11. We sought to evaluate the impact of asking healthcare workers to systematically identify current smokers attending routine HIV ambulatory care appointments and provide VBA.…”