Pilot evaluation of a brief intervention to improve nicotine patch adherence among smokers living with HIV/AIDS.

Abstract

Nicotine replacement therapy is an effective intervention for smoking cessation, but adherence tends to be low. This paper presents results from a pilot evaluation of a brief smoking cessation treatment to improve adherence to the nicotine patch among Latino smokers living with HIV/ AIDS. Forty smokers were randomized to receive either a standard 5 A's counseling session and 8-week treatment of nicotine patch, or a similar intervention that added a 10-minute module to the 5 A's counseling that focused on improving adherence to the nicotine patch. Smoking outcomes (CO verified 7-day point prevalence and continuous abstinence) were evaluated through a 3-month follow-up. Patch usage during the follow-up period was also assessed. Intention to treat analyses indicated that abstinence rates were 2-3 times higher in the adherence condition compared to the standard condition (7-day point prevalence abstinence: 35.0% vs. 15.0%; continuous abstinence: 30.0% vs. 10.0%). Nicotine patch compliance over an 8-week period was also higher in the adherence condition than the standard condition (44% vs. 25%). Although this small pilot was conducted to estimate effect sizes, and was not powered to detect group differences, results are promising and suggest that adding a 10-minute module focused on nicotine patch adherence to a standard 5 A's protocol can increase abstinence rates. Given that this smoking cessation treatment was not specifically tailored to either HIV-positive smokers or Latino smokers, future research should examine whether it may be a promising approach for improving nicotine patch adherence in the general population of smokers.

Barriers and Facilitators of Adherence to Nicotine Replacement Therapy: A Systematic Review and Analysis Using the Capability, Opportunity, Motivation, and Behaviour (COM-B) Model

“…Being able to identify and prevent personal triggers reduces the risk of relapse and adherence to NRT. This finding is similar with a randomised trial that aimed at identifying and avoiding temptations to smoke, which helped improve adherence at eight weeks as well as self-reported abstinence rates [61].…”

Barriers and Facilitators of Adherence to Nicotine Replacement Therapy: A Systematic Review and Analysis Using the Capability, Opportunity, Motivation, and Behaviour (COM-B) Model

“…Being able to identify and prevent personal triggers reduces the risk of relapse and adherence to NRT. This finding is similar with a randomised trial that aimed at identifying and avoiding temptations to smoke, which helped improve adherence at eight weeks as well as self-reported abstinence rates [61].…”

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

“…The average age of the study population was 45 years (range 42-50), and women comprised about 37% (range 8%-100%). Smoking cessation strategies were administered face-to-face in 7 studies [23-27,29,30], and sustained smoking abstinence estimates were reported in 4 studies [23,30-32]. The intensity and maximum follow-up period ranged from 4 weeks to as much 52 weeks.…”

Mixed Methods Process Evaluation of Behavioral Support and Nicotine Replacement Therapy for Smokeless Tobacco Cessation in Bangladesh, India, and Pakistan

“…Also, the provision of additional information and support, particularly around side effects of NRT, and their management should be considered, as similar strategies have been shown to improve knowledge and adherence elsewhere. 33 , 34 The provision of alternate NRT flavors, as was done in India, and other pharmacotherapies (eg, varenicline and cytisine) should also be explored. 35 , 36 …”

Barriers and Facilitators of Adherence to Nicotine Replacement Therapy: A Systematic Review and Analysis Using the Capability, Opportunity, Motivation, and Behaviour (COM-B) Model

“…Being able to identify and prevent personal triggers reduces the risk of relapse and adherence to NRT. This finding is similar with a randomised trial that aimed at identifying and avoiding temptations to smoke, which helped improve adherence at eight weeks as well as self-reported abstinence rates [61].…”

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

“…The average age of the study population was 45 years (range 42-50), and women comprised about 37% (range 8%-100%). Smoking cessation strategies were administered face-to-face in 7 studies [23-27,29,30], and sustained smoking abstinence estimates were reported in 4 studies [23,30-32]. The intensity and maximum follow-up period ranged from 4 weeks to as much 52 weeks.…”

Mixed Methods Process Evaluation of Behavioral Support and Nicotine Replacement Therapy for Smokeless Tobacco Cessation in Bangladesh, India, and Pakistan

“…Also, the provision of additional information and support, particularly around side effects of NRT, and their management should be considered, as similar strategies have been shown to improve knowledge and adherence elsewhere. 33 , 34 The provision of alternate NRT flavors, as was done in India, and other pharmacotherapies (eg, varenicline and cytisine) should also be explored. 35 , 36 …”

Barriers and Facilitators of Adherence to Nicotine Replacement Therapy: A Systematic Review and Analysis Using the Capability, Opportunity, Motivation, and Behaviour (COM-B) Model

“…Being able to identify and prevent personal triggers reduces the risk of relapse and adherence to NRT. This finding is similar with a randomised trial that aimed at identifying and avoiding temptations to smoke, which helped improve adherence at eight weeks as well as self-reported abstinence rates [61].…”

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

“…The average age of the study population was 45 years (range 42-50), and women comprised about 37% (range 8%-100%). Smoking cessation strategies were administered face-to-face in 7 studies [23-27,29,30], and sustained smoking abstinence estimates were reported in 4 studies [23,30-32]. The intensity and maximum follow-up period ranged from 4 weeks to as much 52 weeks.…”

Mixed Methods Process Evaluation of Behavioral Support and Nicotine Replacement Therapy for Smokeless Tobacco Cessation in Bangladesh, India, and Pakistan

“…Also, the provision of additional information and support, particularly around side effects of NRT, and their management should be considered, as similar strategies have been shown to improve knowledge and adherence elsewhere. 33 , 34 The provision of alternate NRT flavors, as was done in India, and other pharmacotherapies (eg, varenicline and cytisine) should also be explored. 35 , 36 …”