{"id":1674,"date":"2009-06-03T19:19:52","date_gmt":"2009-06-03T19:19:52","guid":{"rendered":"http:\/\/localhost.localdomain\/wpmu\/htb\/?p=1674"},"modified":"2013-08-16T13:38:25","modified_gmt":"2013-08-16T13:38:25","slug":"intensive-smoking-cessation-programme-reports-limited-success-at-6-months","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/1674","title":{"rendered":"Intensive smoking cessation programme reports limited success at 6 months"},"content":{"rendered":"

Simon Collins, HIV i-Base<\/strong><\/p>\n

The scale of the problem of smoking, often highlighted in discussions of the abacavir data with a comment such as \u0091patients would reduce their risk more from stopping smoking rather than discontinuing abacavir’ is not only unhelpful for non- and ex-smokers, but also of limited benefit for current smokers who have unsuccessfully tried to quit.<\/strong><\/p>\n

Karen Tashima presented results showing a limited 6 month success rate (~10%) in around 450 HIV-positive US smokers (average 18\/day), randomised to more intense motivational interventions (ME; 4 long (30 minute) counselling sessions) compared to standard of care (SC; 2 brief 3 minute sessions), both with nicotine patches. While the study as a whole found no additional benefit to the ME programme, it had significant differences by race.<\/p>\n

Only around 50% and 60% of patients attended the 2- and 4-month follow-up visits with an increase to 72% at 6-month possibly related to greater financial compensation at that time point. Overall, 6-month quit rates by intent-to-treat analysis were 9% (9% ME, 10% SC, p = 0.76).<\/p>\n

Higher quit rates were seen among Hispanic patients (19% overall, 14% ME, 24% SC) and lowest among African Americans (5% overall, 9% ME, 0% SC), with significant differences in the standard care arm (p = 0.01). Failure to use nicotine replacement predicted smoking at 6 months (p<0.05).<\/p>\n

Multivariate predictors of 6-month smoking abstinence among patch users included black race vs white (p=0.003), baseline self-ability or change in self-ability to refuse ciarettes (p<0.001), change in belief to quit (p=0.003).<\/p>\n

Comment<\/h3>\n

Most commentators found these results depressing, including the presenter, although it was also pointed out that many people need to attend several programmes before they are successful.<\/strong><\/p>\n

Indeed, 68% of participants had previously used nicotine patches and 20% had previously managed to quit for over one year: highlighting the fragility of even these modest success rates.<\/strong><\/p>\n

Patients did not have to express an interest in trying to quit and the financial reimbursement may have encourged particpants with a low motivation. This intervention may have looked more impressive if patients had been selected more appropriately.<\/strong><\/p>\n

Reference:<\/p>\n

Tashima K et al. Positive paths: a motivational intervention for smoking cessation among HIV+ smokers. Oral abstract 148.
\nhttp:\/\/www.retroconference.org\/2009\/Abstracts\/35613.htm<\/a> <\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

Simon Collins, HIV i-Base The scale of the problem of smoking, often highlighted in discussions of the abacavir data with a comment such as \u0091patients would reduce their risk more from stopping smoking rather than discontinuing abacavir’ is not only …<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,8],"tags":[63],"class_list":["post-1674","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-side-effects","tag-croi-2009"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/1674","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=1674"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/1674\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=1674"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=1674"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=1674"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}