Project Overview +

Cigarette smoking is a leading contributor to mortality among people living with HIV (PLWH) in the highly active antiretroviral therapy (HAART) era, and it is the direct cause of 30% of non-AIDS defining malignancies. It is driving the alarming rise in cardiac events and lung cancers in this highly vulnerable population. The lack of access to proven, effective, culturally appropriate tobacco cessation services represents a health disparity of the first order. The psychosocial profile of the PLWH-smoker community, characterized by high rates of psychiatric comorbidity, drug and alcohol use, and low levels of social support, suggests that achieving high cessation rates will be a great challenge.

Positively Smoke Free is an intensive, multisession, cessation intervention specifically developed for PLWH smokers. It is currently available as a live, group therapy program and also as a web-based version designed for notebook or desktop computers. In its current form, the web-version is not adoptable to the smartphone platform. Pilot data from randomized, controlled, trials of both formats show promise. Mobile Positively Smoke Free will adapt the web-version to a mobile version.

Aims +

1. To adapt Positively Smoke Free to the mobile format for smartphones

2. To test the feasibility (i.e. recruitment, adherence, retention, satisfaction, and cost) of mobile Positively Smoke Free (mPSF) in a cohort of 50 PLWH smokers

3. To complete a pilot randomized controlled trial comparing biochemically confirmed 3-month abstinence rates in subjects (N=50) assigned to the mPSF condition versus those (N=50) assigned to standard care (all subjects will be offered a 3-month supply of nicotine replacement therapy)

4. To conduct exploratory analyses of putative moderators and mediators of program efficacy

Participants +

People living with HIV smokers (N=50 for Aim 2 and N=100 for Aim 3).

Intervention +

Mobile PSF (mPSF) will be a multimodal mobile smoking cessation program for PLWH. It will include eight mobile web sessions, text-messaging, automated phone calls, craving help, and one-tap quitline linkage. The user will access all aspects of the program through a single mPSF screen icon, designed to look like a smartphone app, which opens a menu of mPSF program components (i.e. web sessions, craving help,and quitline).

In this study, mPSF will be offered as an adjunct to clinical care, i.e. subjects will be referred by their clinic providers, and all participants will be offered nicotine replacement therapy through the clinic. If proven successful, mPSF may be worthy of study as a freestanding intervention or as an ancillary quitline service.

Mobile Positively Smoke Free: A mobile intervention to promote cessation in HIV-infected smokers

Sponsor(s)

National Cancer Institute

Principal Investigator:

Jonathan Shuter, MD

Co-Investigator(s):

Lorien Abroms, ScD, MA
Lawrence C. An, MD