Smoking Cessation for Persons Living With HIV: A Review of Currently Available Interventions

Abstract

Smoking among persons living with HIV infection (PLWH) is estimated to be two to three times greater than the general population. Data suggest that cigarette smoking is more common among PLWH because of factors such as lower socioeconomic status, previous or concurrent illicit drug and alcohol use, age, education level, and concurrent depressive symptoms. Cigarette smoking in HIV-infected individuals has been associated with higher risk of certain cancers, infections, and a decrease in response to antiretroviral therapy. Recent guidelines from the U.S. Public Health Service have recommended the use of counseling and pharmacologic therapies for all patients interested in quitting smoking. It is critical for clinicians caring for PLWH to be familiar with these modalities. This article provides an overview of currently available interventions for smoking cessation, reviews considerations for patients with HIV, and discusses clinical implications for nurses and advanced practice clinicians.

Changes in smoking patterns after HIV diagnosis or antiretroviral treatment initiation: a global systematic review and meta-analysis

“…Indeed, only 7.1% of PLWH tried to quit tobacco consumption but failed, corroborating other estimates driven from general smokers [40]. Kwong and Bouchard-Miller showed that quitting tobacco consumption is hard to reach and maintain because of both the addictive potential of nicotine and the withdrawal symptoms that accompany cessation [41]. Although there was no information about the reasons underlying these failures, one can easily suggest that these patients received no support and unsuccessfully tried to quit tobacco use by their own means [42,43].…”

A review of the literature concerning HIV and cigarette smoking: Morbidity and mortality, associations with individual- and social-level characteristics, and smoking cessation efforts

“…For instance, brief interventions lasting 3 minutes resulted in abstinence rates of 13% compared to longer interventions lasting 10 minutes or more, which resulted in abstinence rates of 22% (Reus & Smith, 2008; Fiore et al, 2008). One advantage of utilizing counseling interventions is that they can be provided by a variety of types of providers such as physicians, nurses, social workers, and health educators (Kwong & Bouchard-Miller, 2010). …”

“…Moreover, the method of nicotine delivery from NRT products is different than when smoking cigarettes. As a result, NRT can reduce, but not necessarily eliminate craving or withdrawal symptoms (Kwong & Bouchard-Miller, 2010). Nevertheless, a Cochrane review reported that any form of NRT was more effective than placebo in helping smokers to quit (Stead et al, 2008).…”

Smoking-Cessation Interventions in People Living With HIV Infection: A Systematic Review

“…Similar to previous smoking-cessation studies in PLWHs (Kwong & Bouchard-Miller, 2010), this review highlights the need for interventions that utilize multiple strategies and deliver interventions at multiple sessions (Cummins et al, 2005; Elzi et al, 2006; Moadel et al, 2012; Vidrine et al, 2006; Vidrine et al, 2012). Notably, the high rate of recidivism among smokers highlights the importance of follow-up to ensure continuous smoking cessation in PLWHs.…”