Elexis C Kierstead1,2, Emily Harvey3, Denisse Sanchez4, Kimberly Horn5,6, Lorien C Abroms7, Freya Spielberg8, Cassandra A Stanton9, Charles Debnam10, Amy M Cohn11, Tiffany Gray12, Manya Magnus13, Minal Patel4, Raymond Niaura14, Jessica L Elf15. 1. Schroeder Institute, Truth Initiative, 900 G St. NW, Washington, DC, USA. lkierstead@truthinitiative.org. 2. Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA. lkierstead@truthinitiative.org. 3. The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA. 4. Schroeder Institute, Truth Initiative, 900 G St. NW, Washington, DC, USA. 5. Carilion Fralin Biomedical Research Institute at VTC, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA. 6. Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA. 7. Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, USA. 8. Department of Population Health, Dell Medical School, University of Texas, Austin, TX, USA. 9. Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA. 10. Community Wellness Alliance, Washington, DC, USA. 11. Department of Pediatrics, University of Oklahoma College of Medicine, Oklahoma City, OK, USA. 12. Department of Community Health Administration, Department of Health, Washington, DC, USA. 13. Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA. 14. Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City, NY, USA. 15. Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine & Biomedical Sciences, Fort Collins, CO, USA.
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.
RCT Entities:
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.
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