The rates of cardiovascular disease (CVD) are high among people living with HIV. Two of the factors thought to contribute to this inflated risk are increased smoking rates and the prevalence of depression in people living with HIV. Smoking is a direct risk factor for CVD and depression makes quitting smoking and remaining smoke-free more difficult. Therefore, the increase in depression and smoking rates may interact to increase the rates of CVD in people living with HIV. CTNPT 008 looked at the effectiveness of a counselling programme, in combination with nicotine replacement therapy (nicotine patch) to improve quitting rates. The counselling sessions focused on quitting smoking and addressing depression.
Fifty participants were recruited from the Ottawa Hospital. Participants had to be a current smoker, willing to quit within 30 days, diagnosed with HIV, and currently on antiretroviral therapy.
The study used a 24-week counselling design with a 6-month follow up. Counselling sessions occurred at baseline, quit date, and 4, 12, and 24 weeks after quitting. Abstinence from smoking was assessed using self-report questionnaires and biochemical measurement (exhaled carbon monoxide). Psychological and physiological measurements were repeated 6 months following the 24-week counselling period. Study participants were also given telephone-based support throughout the counselling period.
Results and Conclusions
At 6-month follow-up, 28% of participants demonstrated biochemically verified abstinence from smoking. This is considered a successful smoking intervention and compares well to other similar studies. At baseline, 52% of study participants showed signs of clinical depression. At 6-month follow-up, there was a trend towards a decrease in depression. Those with depression were not more likely to relapse back to smoking. This highlights the importance of including depression in counselling sessions to address this barrier to stopping smoking successfully. This pilot trial showed the importance of this type of program to help people with HIV quit smoking.
Dr. Louise Balfour
Ottawa Hospital and the University of Ottawa
Balfour L, Wiebe SA, Cameron WD, Sandre D, Pipe A, Cooper C, Angel J, Garber G, Holly C, Dalgleish TL, Tasca GA, MacPherson PA. An HIV-tailored quit-smoking counselling pilot intervention targeting depressive symptoms plus Nicotine Replacement Therapy. AIDS Care. 2017 Jan;29(1):24-31. Epub 2016 Jul 19.