The influence of HIV disease events/stages on smoking attitudes and behaviors: project STATE (Study of Tobacco Attitudes and Teachable Events)

Abstract

BackgroundGiven the increase in life expectancy among HIV-positive individuals attributable to antiretroviral therapies, cigarette smoking now represents one of the most salient health risks confronting the HIV-positive population. Despite this risk, very few efforts to date have been made to target persons living with HIV for smoking cessation treatment, and no efforts have been made to explore the role of cognitions and HIV disease events/stages on smoking outcomes. The purpose of the study, Project STATE (Study of Tobacco Attitudes and Teachable Events), is to prospectively examine the relationship between HIV events/stages, perceived impact of HIV disease, attitudes about cigarette smoking, and smoking behaviors.Methods/DesignThis study employs a prospective design. Patients are recruited at the time of their first physician visit at a large inner city HIV-clinic – Thomas Street Health Center (TSHC). Consenting participants then complete a baseline assessment. All participants are offered standard care smoking cessation treatment. Follow-up assessments are completed on four subsequent occasions: 3, 6, 9, and 12 months post-baseline. These follow-up assessments are scheduled to coincide with routine clinic appointments with their TSHC physicians. In addition, each participant is given a prepaid cell phone at the time of enrollment and asked to complete brief phone assessments weekly for the first three months of the study period.DiscussionBy evaluating events/stages of HIV disease as potential teaching moments for smoking cessation, findings from this study could be used to develop treatments tailored to an individual’s stage of HIV disease. This study design will enable us to carefully track changes in smoking behavior over time, and to link these changes to both the course of HIV disease and/or to the participant’s’ perceived impact of HIV. By identifying optimal time points for intervention, the findings from this study will have the potential to maximize the efficiency and efficacy of cessation treatments delivered in resource-limited settings. In addition, the findings will be instrumental in identifying specific constructs that should be targeted for intervention and will provide a strong foundation for the development of future cessation interventions targeting smokers living with HIV/AIDS.

Motivation to quit smoking among HIV-positive smokers in Vietnam

“…On the other hand, very few non-motivated smokers (7.8%) reported attempting to quit in the past year. These findings are congruent with the conceptual framework proposed by Vidrine et al [ 35 ] in which smoking attitudes influence changes in smoking behavior. Also, previous research indicates that motivation to quit is positively associated with a number of quit attempts [ 36 , 37 ] and successful abstinence [ 11 , 38 ].…”

“…In contrast, pain could be a facilitator for smoking abstinence. Other research, such as Vidrine et al’s framework [ 35 ], indicates that smokers with higher perceived impact of an HIV-related event (i.e., pain, or symptom burden) may be more likely to change their attitudes on smoking. Future research should fully elucidate this association.…”

Characteristics of intermittent smokers and their association with quit intentions in a sample of heavy-drinking HIV-infected men who have sex with men

“…Participants were asked whether or not they planned to quit smoking and when (i.e., planning to quit smoking within 30 days, planning to quit within the next 6 months, planning to quit sometime in the future, but not within the next 6 months, or no plans to quit). In the general population, quit intentions have been shown to be predictive of quit attempts and smoking cessation (Rose, Chassin, Presson, & Sherman, 1996) and has been used successfully in samples of HIV-infected adults (Vidrine et al, 2014). For quit intentions, a three-category variable was created: (1) immediate (i.e., within the next 30 days); (2) future (i.e., within 6 months or more); and, (3) no plans to quit.…”

Cancer prevention in HIV-infected populations

“…The most important intervention to increase smoking cessation rates is the assessment and discussion of the topic between patients and health care providers 205 . Smoking cessation programs tailored to HIV infected patients have also proven to be effective in achieving this goal 206,207 . Patients with HIV often face significant barriers to cessation that must be recognized and addressed in order to improve the chances of successful abstinence.…”