The role of pain in quitting among human immunodeficiency virus (HIV)-positive smokers enrolled in a smoking cessation trial.
Smoking rates among people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS; PLWHA) are at least twice as high as rates in the general population. Consistent with the reciprocal model of pain and smoking, PLWHA with pain who smoke may use smoking as a means of coping with pain, thus presenting a potential barrier to quitting. The aim of this study is to better understand how pain relates to smoking cessation among 474 HIV-positive adults enrolled in a cell phone-delivered smoking cessation trial.



Participants were randomly assigned to usual care (cessation advice and self-help materials) or 11 sessions of cell phone-delivered smoking cessation treatment. Pain, as assessed by the Medical Outcomes Study-HIV Health Survey (MOS-HIV), and point prevalence abstinence were collected at the 3-month treatment end and at 6- and 12-month follow-ups. Self-reported abstinence was biochemically verified by expired carbon monoxide (CO) level of <7 ppm.



Using multilevel modeling for binary outcome data, the authors examined the relationship between pain and abstinence, from treatment end through the 12-month follow-up. Consistent with the authors' hypothesis, less pain was associated with greater likelihood of 24-hour (β = .01, t(651) = 2.53, P = .01) and 7-day (β = .01, t(651) = 2.35, P = .02) point prevalence abstinence, controlling for age, gender, baseline pain, nicotine dependence, and treatment group. No pain × treatment group interaction was observed.



These results can help us to better identify PLWHA at greater risk for relapse in smoking cessation treatment. Future research may examine the effectiveness of more comprehensive smoking cessation treatment that incorporates aspects of pain management for PLWHA who smoke and have high pain and symptom burden.
a Department of Psychology , Humboldt State University , Arcata , California , USA.
Carrie J
CJ
Aigner
b Department of Behavioral Science , The University of Texas MD Anderson Cancer Center , Houston , Texas , USA.
Ellen R
ER
Gritz
b Department of Behavioral Science , The University of Texas MD Anderson Cancer Center , Houston , Texas , USA.
Irene
I
Tamí-Maury
b Department of Behavioral Science , The University of Texas MD Anderson Cancer Center , Houston , Texas , USA.
George P
GP
Baum
c Division of Infectious Diseases , McGovern Medical School at The University of Texas Health Science Center at Houston , Houston , Texas , USA.
Roberto C
RC
Arduino
d Stephenson Cancer Center at the University of Oklahoma Health Sciences Center , Oklahoma City , Oklahoma , USA.
Damon J
DJ
Vidrine
D000328:Adult; D040421:Cell Phone; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000523:psychology*; D006801:Humans; D008297:Male; D010146:Pain / Q000150:complications* / Q000523:psychology*; D010147:Pain Measurement; D000074285:Smokers / Q000523:psychology*; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology* / Q000706:statistics & numerical data; D014029:Tobacco Use Disorder / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D055815:Young Adult
HIV-positive smokers; pain; smoking cessation; symptom management