title: An HIV-tailored quit-smoking counselling pilot intervention targeting depressive symptoms plus Nicotine Replacement Therapy.
abstract: Cardiovascular disease (CVD) rates among people living with HIV/AIDS (PHAs) are high. Rates of cigarette smoking, a leading contributor to CVD among PHAs, are 40-70% (2-3 times higher than the general population). Furthermore, PHAs have high rates of depression (40-60%), a risk factor for smoking cessation relapse. The current pilot study examined the effectiveness of a specifically tailored 5-session smoking cessation counselling programme for PHAs, which addressed depression, in combination with Nicotine Replacement Therapy (NRT) in a cohort of PHA smokers (n = 50). At 6-month follow-up, 28% of participants demonstrated biochemically verified abstinence from smoking. This result compares favourably to other quit-smoking intervention studies, particularly given the high percentage of HIV+ smokers with depression. At study baseline, 52% of HIV+ smokers scored above the clinical cut-off for depression on the Centre for Epidemiological Studies - Depression (CES-D) scale. HIV+ smokers with depression at study baseline demonstrated quantitatively lower depression at 6-month follow-up with a large effect size (d = 1), though it did not reach statistical significance (p = .058). Furthermore, those with depression were no more likely to relapse than those without depression (p = .33), suggesting that our counselling programme adequately addressed this significant barrier to smoking cessation among PHAs. Our pilot study indicates the importance of tailored programmes to help PHAs quit smoking, the significance of addressing depressive symptoms, and the need for tailored counselling programmes to enhance quit rates among PHAs.
authors.affiliation: a Department of Psychology , The Ottawa Hospital , Ottawa , ON , Canada.|b Department of Psychology , The University of Ottawa , Ottawa , ON , Canada.|c The Ottawa Hospital Research Institute , Ottawa , ON , Canada.|d Department of Medicine , The Ottawa Hospital, University of Ottawa, Ottawa Hospital Research Institute , Ottawa , ON , Canada.
authors.forename: Louise
authors.initials: L
authors.lastname: Balfour
authors.affiliation: a Department of Psychology , The Ottawa Hospital , Ottawa , ON , Canada.|b Department of Psychology , The University of Ottawa , Ottawa , ON , Canada.|c The Ottawa Hospital Research Institute , Ottawa , ON , Canada.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Wiebe
authors.affiliation: e Division of Infectious Diseases , The Ottawa Hospital, Ottawa Hospital Research Institute, Faculty of Medicine, University of Ottawa , Ottawa , ON , Canada.
authors.forename: William D
authors.initials: WD
authors.lastname: Cameron
authors.affiliation: a Department of Psychology , The Ottawa Hospital , Ottawa , ON , Canada.|b Department of Psychology , The University of Ottawa , Ottawa , ON , Canada.|c The Ottawa Hospital Research Institute , Ottawa , ON , Canada.
authors.forename: Daniella
authors.initials: D
authors.lastname: Sandre
authors.affiliation: f The University of Ottawa Heart Institute , Ottawa , ON , Canada.|g Ottawa Hospital Research Institute , Ottawa , ON , Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Pipe
authors.affiliation: e Division of Infectious Diseases , The Ottawa Hospital, Ottawa Hospital Research Institute, Faculty of Medicine, University of Ottawa , Ottawa , ON , Canada.
authors.forename: Curtis
authors.initials: C
authors.lastname: Cooper
authors.affiliation: e Division of Infectious Diseases , The Ottawa Hospital, Ottawa Hospital Research Institute, Faculty of Medicine, University of Ottawa , Ottawa , ON , Canada.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Angel
authors.affiliation: h Faculty of Medicine , University of Ottawa, Ottawa Hospital Research Institute , Ottawa , ON , Canada.
authors.forename: Gary
authors.initials: G
authors.lastname: Garber
authors.affiliation: a Department of Psychology , The Ottawa Hospital , Ottawa , ON , Canada.|b Department of Psychology , The University of Ottawa , Ottawa , ON , Canada.|c The Ottawa Hospital Research Institute , Ottawa , ON , Canada.
authors.forename: Crystal
authors.initials: C
authors.lastname: Holly
authors.affiliation: i Greenbelt Family Health Team , Nepean , ON , Canada.|j Ottawa Couple and Family Institute , Ottawa , ON , Canada.
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Dalgleish
authors.affiliation: a Department of Psychology , The Ottawa Hospital , Ottawa , ON , Canada.|b Department of Psychology , The University of Ottawa , Ottawa , ON , Canada.|k Department of Psychology , Carleton University , Ottawa , ON , Canada.
authors.forename: Giorgio A
authors.initials: GA
authors.lastname: Tasca
authors.affiliation: e Division of Infectious Diseases , The Ottawa Hospital, Ottawa Hospital Research Institute, Faculty of Medicine, University of Ottawa , Ottawa , ON , Canada.
authors.forename: Paul A
authors.initials: PA
authors.lastname: MacPherson
mesh_terms: D000328:Adult; D003376:Counseling; D003863:Depression / Q000150:complications / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012907:Smoking / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D061485:Tobacco Use Cessation Devices; D055815:Young Adult
keywords: HIV/AIDS; Smoking cessation; cardiovascular disease; depression