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

Abstract

Tobacco smoking remains a prevalent behavior in people living with HIV infection (PLWHs) and is associated with impaired immune functioning, increased cardiovascular risk, and decreased response to antire-troviral therapy. This review presents a critique and synthesis of evidence on effective smoking-cessation interventions for PLWHs. A comprehensive search identified nine peer-reviewed intervention studies published between 1989 and 2012. The highest likelihood of smoking cessation (range of odds ratios 4.33–5.6) were in two randomized controlled trial interventions using cell phone technology. Clinically significant reductions in systolic blood pressure, weight gain, and increased CD4+ T-cell count were reported in participants who ceased smoking in three of the nine studies. Overall, multistrategy smoking-cessation interventions, delivered over multiple sessions, were effective. However, the most effective interventions were tailored to the unique individual needs of PLWHs, including assessment of and intervention for polysubstance abuse and mental health issues, as well as the inclusion of access-promoting elements.

Impact of HIV infection and smoking on lung immunity and related disorders

“…Notably, HIV-infected individuals appear to smoke more than the general population. For example, studies in European and North American HIV-infected cohorts report a smoking prevalence ranging from 40% to >70%, two to three times that of the general population [5][6][7][8][9][10][11]. Notwithstanding the increased prevalence of smoking, HIV-infected smokers have a significant, albeit unexplained, increased mortality and decreased quality of life compared to HIV-uninfected smokers [12].…”

Mediators of a smoking cessation intervention for persons living with HIV/AIDS

“…To date, relatively few efforts to evaluate and/or implement smoking cessation interventions for PLWH appear in the literature (Moscou-Jackson et al, 2014). Moreover, published results from randomized clinical trials (RCT) generally indicate modest long- term smoking abstinence rates and small, or no treatment group differences (Gritz et al, 2013; Humfleet et al, 2013; Lloyd-Richardson et al, 2009).…”

HIV/AIDS, tuberculose e tabagismo no Brasil: uma sindemia que exige intervenções integradas

“…A 2014 review of cessation interventions among persons living with HIV/AIDS indicated that these must take into account social context, mental health, and other risk behaviors. Multiple, varied interventions delivered consistently over time were most successful 20 .…”