Motivation and patch treatment for HIV+ smokers: a randomized controlled trial.
OBJECTIVE
To test the efficacy of two smoking cessation interventions in a HIV positive (HIV+) sample: standard care (SC) treatment plus nicotine replacement therapy (NRT) versus more intensive motivationally enhanced (ME) treatment plus NRT.


METHODS
Randomized controlled trial.


METHODS
HIV+ smoker referrals from eight immunology clinics in the northeastern United States.


METHODS
A total of 444 participants enrolled in the study (mean age = 42.07 years; 63.28% male; 51.80% European American; mean cigarettes/day = 18.27).


METHODS
SC participants received two brief sessions with a health educator. Those setting a quit date received self-help quitting materials and NRT. ME participants received four sessions of motivational counseling and a quit-day counseling call. All ME intervention materials were tailored to the needs of HIV+ individuals.


METHODS
Biochemically verified 7-day abstinence rates at 2-month, 4-month and 6-month follow-ups.


RESULTS
Intent-to-treat (ITT) abstinence rates at 2-month, 4-month and 6-month follow-ups were 12%, 9% and 9%, respectively, in the ME condition, and 13%, 10% and 10%, respectively, in the SC condition, indicating no between-group differences. Among 412 participants with treatment utilization data, 6-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% confidence interval = 0.99-1.75).


CONCLUSIONS
Motivationally enhanced treatment plus NRT did not improve cessation rates over and above standard care treatment plus NRT in this HIV+ sample of smokers. Providers offering brief support and encouraging use of nicotine replacement may be able to help HIV+ patients to quit smoking.
Lloyd-Richardson
Elizabeth E
EE
Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA. erichardson@umassd.edu
Stanton
Cassandra A
CA
Papandonatos
George D
GD
Shadel
William G
WG
Stein
Michael
M
Tashima
Karen
K
Flanigan
Timothy
T
Morrow
Kathleen
K
Neighbors
Charles
C
Niaura
Raymond
R
D000279:Administration, Cutaneous; D000328:Adult; D001741:Black or African American; D003376:Counseling / Q000379:methods*; D005260:Female; D006679:HIV Seropositivity / Q000208:ethnology / Q000523:psychology*; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D009042:Motivation; D009511:New England; D009538:Nicotine / Q000008:administration & dosage; D015397:Program Evaluation; D012907:Smoking / Q000188:drug therapy* / Q000208:ethnology; D016540:Smoking Cessation / Q000208:ethnology / Q000379:methods*; D016896:Treatment Outcome; D044465:White People
D009538:Nicotine