Motivation and patch treatment for HIV+ smokers

A randomized controlled trial

Elizabeth E. Lloyd-Richardson, Cassandra A. Stanton, George D. Papandonatos, William G. Shadel, Michael Stein, Karen Tashima, Timothy Flanigan, Kathleen Morrow, Charles Neighbors, Raymond Niaura

Research output: Contribution to journalArticle

Abstract

Aims 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. Design Randomized controlled trial. Setting HIV+ smoker referrals from eight immunology clinics in the northeastern United States. Participants 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). Interventions 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. Measurements Biochemically verified 7-day abstinence rates at 2-month, 4-month and 6-month follow-ups. Findings 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.

Original languageEnglish (US)
Pages (from-to)1891-1900
Number of pages10
JournalAddiction
Volume104
Issue number11
DOIs
StatePublished - Nov 2009

Fingerprint

Motivation
Randomized Controlled Trials
HIV
Nicotine
Therapeutics
Counseling
Smoking
Health Educators
Tobacco Use Disorder
New England
Smoking Cessation
Allergy and Immunology
Hispanic Americans
Tobacco Products
Referral and Consultation
Odds Ratio
Confidence Intervals

Keywords

  • Health disparities
  • HIV
  • HIV positive
  • Nicotine replacement
  • Smoking cessation
  • Tobacco cessation
  • Transtheoretical Model

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health

Cite this

Lloyd-Richardson, E. E., Stanton, C. A., Papandonatos, G. D., Shadel, W. G., Stein, M., Tashima, K., ... Niaura, R. (2009). Motivation and patch treatment for HIV+ smokers: A randomized controlled trial. Addiction, 104(11), 1891-1900. https://doi.org/10.1111/j.1360-0443.2009.02623.x

Motivation and patch treatment for HIV+ smokers : A randomized controlled trial. / Lloyd-Richardson, Elizabeth E.; Stanton, Cassandra A.; Papandonatos, George D.; Shadel, William G.; Stein, Michael; Tashima, Karen; Flanigan, Timothy; Morrow, Kathleen; Neighbors, Charles; Niaura, Raymond.

In: Addiction, Vol. 104, No. 11, 11.2009, p. 1891-1900.

Research output: Contribution to journalArticle

Lloyd-Richardson, EE, Stanton, CA, Papandonatos, GD, Shadel, WG, Stein, M, Tashima, K, Flanigan, T, Morrow, K, Neighbors, C & Niaura, R 2009, 'Motivation and patch treatment for HIV+ smokers: A randomized controlled trial', Addiction, vol. 104, no. 11, pp. 1891-1900. https://doi.org/10.1111/j.1360-0443.2009.02623.x
Lloyd-Richardson EE, Stanton CA, Papandonatos GD, Shadel WG, Stein M, Tashima K et al. Motivation and patch treatment for HIV+ smokers: A randomized controlled trial. Addiction. 2009 Nov;104(11):1891-1900. https://doi.org/10.1111/j.1360-0443.2009.02623.x
Lloyd-Richardson, Elizabeth E. ; Stanton, Cassandra A. ; Papandonatos, George D. ; Shadel, William G. ; Stein, Michael ; Tashima, Karen ; Flanigan, Timothy ; Morrow, Kathleen ; Neighbors, Charles ; Niaura, Raymond. / Motivation and patch treatment for HIV+ smokers : A randomized controlled trial. In: Addiction. 2009 ; Vol. 104, No. 11. pp. 1891-1900.
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abstract = "Aims 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. Design Randomized controlled trial. Setting HIV+ smoker referrals from eight immunology clinics in the northeastern United States. Participants 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). Interventions 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. Measurements Biochemically verified 7-day abstinence rates at 2-month, 4-month and 6-month follow-ups. Findings 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.",
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AB - Aims 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. Design Randomized controlled trial. Setting HIV+ smoker referrals from eight immunology clinics in the northeastern United States. Participants 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). Interventions 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. Measurements Biochemically verified 7-day abstinence rates at 2-month, 4-month and 6-month follow-ups. Findings 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.

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