Behavioral interventions for tobacco Use in HIV-infected smokers: A meta-analysis

CONTEXT: Smoking is responsible for increased morbidity and mortality in HIV-infected smokers OBJECTIVE:: To assess the efficacy of behavioral interventions for smoking cessation among HIV-infected smokers compared to the standard care. DATA SOURCES: PubMed, Cochrane, CINHAL, PsychINFO, and Google Scholar were searched for randomized controlled trials published in English. STUDY SELECTION: Eligibility criteria were randomized controlled trials with targeted behavioral interventions compared to standard of care (or enhanced standard of care) aimed at promoting abstinence in HIV-infected smokers. 17,384 articles were found, 17,371 were excluded. 13 full text articles were obtained and reviewed, and 8 met eligibility criteria (Kappa=0.94). DATA EXTRACTION: The primary outcome was expired carbon monoxide (ECO)-verified 7-day point prevalence abstinence (PPA) rates. Adequate sequence generation and freedom from incomplete or selective outcome reporting was used to asses study quality. RESULTS: A total of 1822 subjects from eight studies yielded a statistically significant effect of behavioral interventions in increasing abstinence in HIV-infected smokers with a moderate effect size RR 1.51 (95% CI 1.17, 1.95). Those studies with interventions of eight sessions or more had a large effect size for abstinence RR 2.88 (95% CI: 1.89–4.61). When stratified by the number of sessions there was no heterogeneity. CONCLUSIONS: Targeted behavioral smoking cessation interventions are efficacious. Interventions consisting of eight sessions or more had the greatest treatment efficacy.

• Population(s)
  • Other
• Substance Use
  • Tobacco