Smoking Cessation: Innovative Group Therapy-Centered Support Found to Double Quit Rate

Results

Overall, 21 participants (15%) were able to quit after the three-month program ended, distributed as follows:

• PSF: 19%
• standard therapy: 10%

Although the outcome of this study is highly promising and likely clinically meaningful -- nearly twice as many PSF participants quit -- the difference in quit rates did not reach statistical significance.

The study team assessed possible reasons that might have influenced people to quit, including the following:

• group facilitators: a comparison of different group leaders did not find any impact on outcomes
• prescribed medicines: although 40% of participants received nicotine replacement  therapy or other prescribed drugs, such as bupropion (Wellbutrin, Zyban) and varenicline (Chantix, Champix), to help ease the path to quitting, prescribed medicines on their own did not apparently affect quit rates in this study
• race/ethnicity: people of Latino ethnicity were more likely to quit
• loneliness: people who were lonelier were less likely to quit

Improvements to the Next Clinical Trial

The PSF program was clearly advantageous in helping people to quit. Researchers found that quit rates were significantly greater among PSF participants if they attended seven or more counselling sessions and also received prescribed therapy to help them quit. Keeping people motivated in any clinical trial is not easy, particularly in trials of smoking cessation. Future trials should consider prescribed medicines for smoking cessation as well as ways to maximize attendance at support group meetings. Additional considerations include the following:

• race/ethnicity: Researchers are not certain why Latino participants were more likely to quit smoking in the present study. They found that Black people were less likely to quit and so more research is needed to understand these issues concerning race and ethnicity.
• loneliness: Past research has found that loneliness is linked to an increased risk for tobacco use. Perhaps this may be related to boredom and stigmatization, which are also related to the use of tobacco. The social aspects of the PSF program were the most appreciated part of the program by participants. This finding may be useful for future studies.

The present study has produced highly promising results and shows that smoking cessation is possible among HIV-positive people who are motivated to quit. Perhaps future studies should be of a longer duration, both to provide more social support for participants and to assess how long they are able to remain smoke free.

Resources

• CATIE-News: Understanding Tobacco Addiction
• Canadian Cancer Society: Smoking and Tobacco
• Canadian Lung Association: Smoking & Tobacco
• Santé et services sociaux Québec: Tobacco and Your Health
• CATIE: Up in Smoke -- The Ifs, Ands or Buts of Butting Out
• CATIE Factsheet: HIV and Cardiovascular Disease

References

1. Gong J, Hutter CM, Baron JA, et al. A pooled analysis of smoking and colorectal cancer: timing of exposure and interactions with environmental factors. Cancer Epidemiology, Biomarkers & Prevention. 2012; in press.
2. Fabbiani M, Ciccarelli N, Tana M, et al. Cardiovascular risk factors and carotid intima-media thickness are associated with lower cognitive performance in HIV-infected patients. HIV Medicine. 2012; in press.
3. Shuter J, Bernstein SL, Moadel AB. Cigarette smoking behaviors and beliefs in persons living with HIV/AIDS. American Journal of Health Behavior. 2012 Jan;36(1):75-85.
4. Moadel AB, Bernstein SL, Mermelstein RJ, et al. A Randomized Controlled Trial of a Tailored Group Smoking Cessation Intervention for HIV-Infected Smokers. Journal of Acquired Immune Deficiency Syndromes. 2012 Oct 1;61(2):208-215.
5. Lifson AR, Neuhaus J, Arribas JR, et al. Smoking-related health risks among persons with HIV in the Strategies for Management of Antiretroviral Therapy clinical trial. American Journal of Public Health. 2010 Oct;100(10):1896-903.
6. Lauder W, Mummery K, Jones M, et al. A comparison of health behaviours in lonely and non-lonely populations. Psychology, Health, and Medicine. 2006 May;11(2):233-45.