Motivation and Patch Treatment for HIV-Positive Smokers: A Randomized Controlled Trial
January 8, 2010
To test the efficacy of two smoking cessation interventions in an HIV-positive sample from eight immunology clinics in the Northeast, the researchers designed a randomized controlled trial, providing standard care (SC) treatment plus nicotine replacement therapy (NRT) versus more intensive motivationally enhanced (ME) treatment plus NRT.
The study enrolled 444 participants (mean age=42.07 years; 63.28 percent male; 51.08 European-American; mean cigarettes/day=18.27). SC participants received two brief sessions with a health educator. Those setting a quit date received self-help quitting materials and NRT. ME participants underwent four motivational counseling sessions and a quit-day counseling call. All ME intervention materials were tailored to the needs of HIV-positive individuals. Seven-day abstinence rates were biochemically verified at two-, four- and six-month follow-up.
Intent-to-treat (ITT) abstinence rates at two-month, four-month, and six-month follow-up intervals were 12 percent, 9 percent, and 9 percent, respectively, in the ME condition. For the SC condition, ITT rates were 13 percent, 10 percent, and 10 percent, respectively. No between-group differences were observed. Among 412 participants with treatment utilization data, six-month ITT abstinence rates were associated positively with low nicotine dependence (p=0.02), high motivation to quit (p=0.04), and Hispanic-American race/ethnicity (p=0.02). Adjusting for these variables, each additional NRT contact improved the odds of smoking abstinence by a third (odds ratio=1.32, 95 percent confidence interval=0.99-1.75).
In this sample of HIV-positive smokers, the researchers concluded, ME treatment plus NRT did not improve cessation rates over and above SC treatment plus NRT. Providers who offer brief support and encourage NRT use may be able to help HIV patients quit smoking, they added.
11.2009; doi: 10.1111/j.1360-0443.2009.02623.x; Elizabeth E. Lloyd-Richardson, Cassandra A. Stanton, George D. Papandonatos, William G. Shadel, Michael Stein, Karen Tashima, Timothy Flanigan, Kathleen Morrow, Charles Neighbors, Raymond Niaura
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.