title: Evaluation of a Smoking Cessation Program for HIV Infected Individuals in an Urban HIV Clinic: Challenges and Lessons Learned.
abstract: Introduction. HIV infected persons have high prevalence of smoking and tobacco-associated health risks. Few studies describe smoking cessation programs targeting this population. The Infectious Disease Practice (IDP) in Newark, New Jersey, initiated a smoking cessation program (SCP) for HIV infected smokers. We report participation, abstinence rates, and predictors of abstinence. Methods. This is a prospective cohort study, comparing participants to non-SCP smokers, during April 1, 2011, to October 31, 2012. Intervention included one individualized counseling session with an offer of pharmacotherapy. Univariate and multivariate analyses were performed with self-reported seven-day point prevalence abstinence at six months as primary outcome measure. Results. Among 1545 IDP patients, 774 (51%) were current smokers of whom 123 (16%) participated in the SCP. Mean six-month abstinence rate amongst SCP participants was 16%. A history of cocaine or heroin use was predictive of continued smoking (odds ratio [OR] adjusted 0.20, 95% confidence interval [CI] 0.07-0.55) while smokers in the preparation stage of change were more likely abstinent at six months (OR adjusted 8.26, 95% CI 1.02-66.67). Conclusions. A low-intensity smoking cessation intervention in an HIV treatment setting is effective in a minority of participants. Further research is needed to better address barriers to smoking cessation such as substance use.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Rutgers New Jersey Medical School, Newark, NJ, USA ; Division of Infectious Diseases, Rutgers New Jersey Medical School, Ambulatory Care Center-Infectious Disease Practice, 140 Bergen Street, Newark, NJ 07103, USA.
authors.forename: Debra
authors.identifier: 0000-0002-5196-7321
authors.initials: D
authors.lastname: Chew
authors.affiliation: Division of General Internal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Steinberg
authors.affiliation: Department of Preventive Medicine and Community Health, Rutgers New Jersey Medical School, Newark, NJ, USA.
authors.forename: Polly
authors.initials: P
authors.lastname: Thomas
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Rutgers New Jersey Medical School, Newark, NJ, USA.
authors.forename: Shobha
authors.initials: S
authors.lastname: Swaminathan
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Rutgers New Jersey Medical School, Newark, NJ, USA.
authors.forename: Sally L
authors.initials: SL
authors.lastname: Hodder