scholarly journals A pilot randomized controlled trial of a tailored smoking cessation program for people living with HIV in the Washington, D.C. metropolitan area

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Elexis C. Kierstead ◽  
Emily Harvey ◽  
Denisse Sanchez ◽  
Kimberly Horn ◽  
Lorien C. Abroms ◽  
...  

Abstract Objective Morbidity and mortality from smoking-related diseases among people living with HIV (PLWH) in the U.S. surpasses that due to HIV itself. Conventional smoking cessation treatments have not demonstrated strong efficacy among PLWH. We conducted a pilot randomized controlled trial (RCT) to evaluate a tailored smoking cessation intervention based on the minority stress model. We compared standard of care counseling (SOC) to a tailored intervention (TI) including one face-to-face counseling session incorporating cognitive behavioral therapy to build resilience, and 30 days of 2-way text messaging. Results The primary outcome was smoking cessation. Secondary outcomes included cigarettes per day (CPD), exhaled carbon monoxide (CO), and cessation self-efficacy. A total of 25 participants were enrolled (TI:11, SOC:14), and 2 were lost to follow-up. There were no significant differences in quit rates between study groups. However, there was a significantly greater decrease in CPD in the TI versus SOC (13.5 vs. 0.0, p-value:0.036). Additionally, self-efficacy increased in both groups (TI p-value:0.012, SOC p-value:0.049) and CO decreased in both groups (TI p-value: < 0.001, SOC p-value:0.049). This intervention shows promise to support smoking cessation among PLWH. A larger study is needed to fully evaluate the efficacy of this approach. Clinical trial: Trial Registration: Retrospectively registered (10/20/2020) NCT04594109.

2020 ◽  
Author(s):  
Elexis C. Kierstead ◽  
Emily Harvey ◽  
Denisse Sanchez ◽  
Kimberly Horn ◽  
Lorien C. Abroms ◽  
...  

Abstract ObjectiveMorbidity and mortality from smoking-related diseases among people living with HIV (PLWH) in the U.S. surpasses that due to HIV itself. Conventional smoking cessation treatments have not demonstrated strong efficacy among PLWH. We conducted a pilot randomized controlled trial (RCT) to evaluate a tailored smoking cessation intervention based on the minority stress model. We compared standard of care counseling (SOC) to a tailored intervention (TI) including one face-to-face counseling session incorporating cognitive behavioral therapy to build resilience, and 30 days of 2-way text messaging.ResultsThe primary outcome was smoking cessation. Secondary outcomes included cigarettes per day (CPD), exhaled carbon monoxide (CO), and cessation self-efficacy. A total of 25 participants were enrolled (TI:11, SOC:14), and 2 were lost to follow up. There were no significant differences in quit rates between study groups. However, there was a significantly greater decrease in CPD in the TI versus SOC (13.5 vs. 0.0, p-value:0.036). Additionally, self-efficacy increased in both groups (TI p-value:0.012, SOC p-value:0.049) and CO decreased in both groups (TI p-value:<0.001, SOC p-value:0.0488). This intervention shows promise to support smoking cessation among PLWH. A larger study is needed to fully evaluate the efficacy of this approach.Trial RegistrationRetrospectively registered (10/20/2020) NCT04594109


2020 ◽  
Vol 4 (6) ◽  
pp. e7570 ◽  
Author(s):  
Christopher W Kahler ◽  
Amy M Cohn ◽  
Catherine Costantino ◽  
Benjamin A Toll ◽  
Nichea S Spillane ◽  
...  

Background Heavy drinking (HD) is far more common among smokers compared with nonsmokers and interferes with successful smoking cessation. Alcohol-focused smoking cessation interventions delivered by counselors have shown promise, but digital versions of these interventions—which could have far greater population reach—have not yet been tested. Objective This pilot randomized controlled trial aimed to examine the feasibility, acceptability, and effect sizes of an automated digital smoking cessation program that specifically addresses HD using an interactive web-based intervention with an optional text messaging component. Methods Participants (83/119, 69.7% female; 98/119, 82.4% white; mean age 38.0 years) were daily smokers recruited on the web from a free automated digital smoking cessation program (BecomeAnEX.org, EX) who met the criteria for HD: women drinking 8+ drinks/week or 4+ drinks on any day and men drinking 15+ drinks/week or 5+ drinks on any day. Participants were randomized to receive EX with standard content (EX-S) or an EX with additional content specific to HD (EX-HD). Outcomes were assessed by web-based surveys at 1 and 6 months. Results Participants reported high satisfaction with the website and the optional text messaging component. Total engagement with both EX-S and EX-HD was modest, with participants visiting the website a median of 2 times, and 52.9% of the participants enrolled to receive text messages. Participants in both the conditions showed substantial, significant reductions in drinking across 6 months of follow-up, with no condition effects observed. Although smoking outcomes tended to favor EX-HD, the condition effects were small and nonsignificant. A significantly smaller proportion of participants in EX-HD reported having a lapse back to smoking when drinking alcohol (7/58, 16%) compared with those in EX-S (18/61, 41%; χ21=6.2; P=.01). Conclusions This is the first trial to examine a digital smoking cessation program tailored to HD smokers. The results provide some initial evidence that delivering such a program is feasible and may reduce the risk of alcohol-involved smoking lapses. However, increasing engagement in this and other web-based interventions is a crucial challenge to address in future work. Trial Registration ClinicalTrials.gov NCT03068611; https://clinicaltrials.gov/ct2/show/NCT03068611


2021 ◽  
Author(s):  
Nan Jiang ◽  
Nam Nguyen ◽  
Nina Siman ◽  
Charles M. Cleland ◽  
Trang Nguyen ◽  
...  

BACKGROUND Text message (i.e., short message service, SMS) smoking cessation interventions have demonstrated efficacy in high-income countries, but are less well studied in low- and middle-income countries. OBJECTIVE To assess the feasibility, acceptability, and preliminary efficacy of a fully-automated bidirectional SMS cessation intervention adapted for smokers in Viet Nam. METHODS We adapted the SMS library from two US-based SMS cessation programs. The adaptation process consisted of 7 focus groups to provide data on culturally relevant patterns of tobacco use and to assess message preferences, and a single-arm pilot test of a 6-week SMS intervention. We then conducted a two-arm pilot randomized controlled trial and randomized 100 smokers to receive either the 6-week SMS program (intervention arm; n=50) or weekly text assessment on smoking status (control arm; n=50). Surveys assessed engagement and acceptability at 6 weeks (end of intervention), and biochemically confirmed smoking abstinence at 6 and 12 weeks. Post-intervention in-depth interviews further explored user experiences and perceptions among participants in the intervention arm. RESULTS Participants in both arms reported high levels of program acceptability and engagement. Compared to the control arm, a higher proportion of participants in the intervention arm reported being satisfied with the program (98% vs. 82%). Biochemically verified abstinence was higher in the intervention arm at 6 weeks (20.0% vs. 2.0%; P=.01), but the effect was not significant at 12 weeks (12.0% vs. 6.0%; P=.49). Qualitative interviews suggested additional modifications to enhance the program including tailoring the timing of messages, adding more opportunities to interact with the program, and placing a greater emphasis on messages that described the harms of tobacco use. CONCLUSIONS The study supported the feasibility and acceptability of a SMS program adapted for Vietnamese smokers. Future studies are needed to assess whether, with additional modifications, the program is associated with prolonged abstinence. CLINICALTRIAL ClinicalTrials.gov NCT03219541


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