1. Is It Feasible to Impact on Smoking Habits in HIV-Infected Patients? Mission Impossible From the STOPSHIV Project Cohort
- Author
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Nicola Squillace, Barbara Menzaghi, Daniela Francisci, Giancarlo Orofino, Elena Ricci, Giuseppe Vittorio De Socio, Paolo Bonfanti, Antonio Di Biagio, Francesca Vichi, Paolo Maggi, Giordano Madeddu, Marco Dell'Omo, De Socio, Gv, Ricci, E, Maggi, P, Orofino, G, Squillace, N, Menzaghi, B, Madeddu, G, Di Biagio, A, Francisci, D, Bonfanti, P, Vichi, F, Dellʼomo, M, De Socio, G, and Dell'Omo, M
- Subjects
Adult ,Counseling ,Male ,medicine.medical_specialty ,media_common.quotation_subject ,medicine.medical_treatment ,HIV Infections ,tobacco ,smoking ,Acquired immunodeficiency syndrome (AIDS) ,cardiovascular disease ,Interquartile range ,Intervention (counseling) ,Humans ,Medicine ,Pharmacology (medical) ,Prospective Studies ,nicotine dependence ,Prospective cohort study ,Fagerstrom ,media_common ,Smokers ,business.industry ,HIV ,Middle Aged ,Abstinence ,medicine.disease ,Survival Analysis ,AIDS ,Infectious Diseases ,Family medicine ,Cohort ,Fagerström ,Smoking cessation ,Female ,Smoking Cessation ,Self Report ,Brief intervention ,business ,Follow-Up Studies - Abstract
OBJECTIVE Assessment of the feasibility and effectiveness of a brief intervention for smoking cessation in people living with HIV (PLWH). SETTING Multicenter cohort prospective study involving PLWH from 10 Italian infectious disease centers. METHODS During routine HIV care, clinicians delivered the 5As brief intervention (Ask, Advise, Assess, Assist, Arrange) to each patient who enrolled in the study, following the European AIDS Clinical Society guidelines. At study end, participating clinicians evaluated their own adherence to intervention: "standard" if counseling was delivered in at least half of the follow-up visits, "soft" if less. The main outcome measure was smoking abstinence ≥6 months. Abstinence predictors were evaluated using a Cox-proportional hazard regression model. RESULTS One thousand eighty-seven PLWH-patients (age 47.9 ± 10.8, male 73.5%) were followed for a median of 23 months (interquartile range 21-25). At baseline, current smokers were 561 (51.6%). Standard intervention was performed in 4 of 10 centers and included 343 smokers; soft intervention was performed in 6 centers (218 smokers). At last visit, 35 patients in standard (10.8%) and 6 in soft intervention (2.8%) achieved self-reported tobacco abstinence ≥6 months (P = 0.0009). Overall, the 5As intervention led to 7.3% 6-month interruptions. In the multivariable analysis, significant predictors for 6-month smoking cessation were: lower Fagerstrom score, stage of change (preparation/contemplation vs. precontemplation), and standard intervention. CONCLUSION Adherence to the 5As brief intervention emerged as a critical factor for success. In fact, compared with soft intervention, the standard intervention significantly increased abstinence, highlighting that clinicians need more time and supporting tools to encourage PLWH to quit smoking.
- Published
- 2020