||5R01CA243907-02 Interpret this number
||Seattle Inst For Biomedical/Clinical Res
||Improving the Reach and Effectiveness of Smoking Cessation Services Targeted to Veterans Living with HIV
Tobacco use remains the leading preventable cause of death and illness in our society, and smoking
rates are disproportionately high among people living with HIV. NCI, nicotine dependence researchers, and
HIV clinicians have all called for research to evaluate targeted and tailored smoking cessation programs for
smokers living with HIV (SLWH), leading to the current request for applications (RFA-CA-18-027). Research
suggests SLWH are largely unaware of the HIV-specific deleterious effects of smoking and often lack
motivation and confidence in their ability to quit. For these reasons, we developed the Wellness Intervention for
Smokers with HIV (WISH). WISH is grounded in the Information-Motivation-Behavioral Skills (IMB) Model and
delivered remotely by mobile phone (voice and text message). The program is designed for all SLWH,
regardless of their initial motivation to quit. WISH follows evidence-based, best practice guidelines for nicotine
dependence treatment, but is innovative in its use of a more comprehensive wellness approach. That is, the
intervention addresses both smoking and a number of other personally relevant health behaviors (such as
treatment adherence, stress/mood, nutrition, other substance use, etc.), making it relevant and engaging to all
SLWH, not just those ready to stop smoking. For those not yet ready to quit, WISH is designed to build and
strengthen motivation and self-efficacy for quitting, while smokers also work on other personal health goals.
Once ready to quit smoking, participants receive evidence-based cognitive-behavioral counseling and
encouragement to use nicotine replacement therapy (NRT) or other appropriate pharmacotherapy. WISH
builds on our extensive experience creating motivationally-enhanced cessation interventions and has been
pilot tested with SLWH. In this trial, we will compare the effectiveness of WISH to standard care services
offered through the National VA Quitline and the SmokefreeVET texting program, NCI-supported tobacco
cessation services available to all Veterans. Participants in both arms can receive phone/ text counseling and
have access to pharmacotherapy through VA. Primary outcomes will be biochemically confirmed 7-day point
prevalence smoking abstinence and presence of any 24-hour intentional quit attempts. Secondary outcomes
will include prolonged abstinence, change in cigarettes per day, intermediate change process outcomes based
on the IMB model, as well as metrics of intervention reach and implementation. Consistent with RFA goals, we
will also describe comorbidities and explore intervention impact on markers of immune status and mortality risk
using the outstanding clinical data resources available through the Veterans Aging Cohort Study (VACS). If
effective, WISH could meaningfully reduce smoking among HIV+ Veterans nationwide. To support this goal,
dissemination efforts are planned in Year 5 to share the WISH program with the National VA Quitline. Because
VA is the largest U.S. provider of HIV care, this research has the potential for significant public health impact.
Receipt and predictors of smoking cessation pharmacotherapy among veterans with and without HIV.
, Crothers K.
, McGinnis K.A.
, Chan K.C.G.
, Baeten J.M.
, Wilson S.M.
, Butt A.A.
, Pisani M.A.
, Baldassarri S.R.
, Justice A.
, et al.
Progress in cardiovascular diseases, 2020 Mar - Apr; 63(2), p. 118-124.