Integrated treatment for smoking cessation, anxiety, and depressed mood in people living with HIV: a randomized controlled trial
Open accessAbstract
Objective: Among people living with HIV, cigarette smoking rates are higher than among the general population, and anxiety, depression, and their disorders are common and associated with smoking and poorer outcomes during cessation. This study evaluated the efficacy of an integrated smoking cessation intervention, developed to target anxiety, depression, and smoking cessation concurrently among people living with HIV. Method: Smokers living with HIV who reported at least moderate motivation to quit smoking were randomized into a novel 9-week integrated intervention (QUIT), consisting of 1 psychoeducation (prerandomization) session and 9 weekly 1-hour sessions of cognitive behavioral therapy for smoking cessation and anxiety/depression plus nicotine replacement therapy, or a 9-week enhanced standard smoking intervention (ETAU), consisting of 1 psychoeducation session (prerandomization) and 4 brief weekly check-in sessions plus nicotine replacement therapy. All were instructed to make a quit attempt at week 6. Results: Seventy-two participants were enrolled, and 53 were randomized. 41/53 participants completed the active treatment phase of the study. 7-day point-prevalence abstinence, verified with expired carbon monoxide, was significantly higher among those in the integrated intervention than those in the enhanced standard intervention both end-of-treatment {[M QUIT = 59%, M ETAU = 9%; b = 5.60, 95% confidence interval: (2.64 to 8.56), t(332) = 3.72, P < 0.001]} and 6-months post-quit date {[M QUIT = 46%, M ETAU = 5%; b = 7.69, 95% confidence interval: (4.60 to 10.78), t(332) = 4.90, P < 0.001]}. Consideration of patterns of missingness did not alter the significance of these findings. Conclusions: The integrated intervention was associated with substantially higher short-term and long-term abstinence rates than the enhanced standard intervention. These data provide promising initial evidence supporting the benefits of an integrated anxiety–depression/smoking cessation program specifically tailored for people living with HIV.
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In the authors' pilot study, compared with enhanced standard of care, smoking abstinence was significantly higher in QUIT at end-of-treatment (QUIT 59%, E-SOC 9%).
“Compared to an enhanced standard-of-care (E-SOC), smoking abstinence was significantly higher in QUIT at end-of-treatment (EOT; QUIT=59%, E-SOC=9%) and 6-month follow-up (6MFU; QUIT=46%, E-SOC=5%).26”
In the authors' pilot study, compared with enhanced standard of care, smoking abstinence was significantly higher in QUIT at 6-month follow-up (QUIT 46%, E-SOC 5%).
“Compared to an enhanced standard-of-care (E-SOC), smoking abstinence was significantly higher in QUIT at end-of-treatment (EOT; QUIT=59%, E-SOC=9%) and 6-month follow-up (6MFU; QUIT=46%, E-SOC=5%).26”
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Self-citation
- Authors
- O'Cleirigh, C., Zvolensky, M. J., Smits, J. A. J., Labbe, A. K., Coleman, J. N., Wilner, J. G., Stanton, A. M., Gonzalez, A., Garey, L., Regenauer, K. S., & Rosenfield, D.
- Affiliations
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA;
- The University of Texas MD Anderson Cancer Center (US)
- The University of Texas at Austin (US)
- Harvard University (US)
- Duke University (US)
- Boston University (US)
- State University of New York (US)
- University of Houston (US)
- Massachusetts General Hospital (US)
- Southern Methodist University (US)
- Corresponding author
- Labbe, Allison K.
- Coleman, Jessica N.
- Wilner, Julianne G.
- Gonzalez, Adam
- Regenauer, Kristen S.
- ORCID
- Venue
- JAIDS Journal of Acquired Immune Deficiency Syndromes
- Published
- 2018-10-01
- Volume
- 79
- Issue
- 2
- Pages
- 261-268
- ISSN
- 1525-4135 (ISSN-L)
- PMC
- PMC10041790
- OpenAlex
- W2810175364
- Cited by
- 41
- References
- 36
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 6 · 2023: 8 · 2022: 2 · 2021: 8 · 2020: 7 · 2019: 3
- FWCI
- 3.09
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAIDS Journal of Acquired Immune Deficiency Syndromes (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (R34DA031038, R01DA047933)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- smoking cessation, HIV, anxiety, depression, integrated intervention, cognitive behavioral therapy, nicotine replacement therapy, abstinence, psychoeducation
- MeSH terms
- Adult, Anxiety, Depression, Female, Humans, Male, Middle Aged, HIV Infections, Smoking Cessation
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