Feasibility and Preliminary Efficacy of a Web-Based Smoking Cessation Intervention for HIV-Infected Smokers: A Randomized Controlled Trial

Shuter, Jonathan MD*; Morales, Daniela A. MPH*; Considine-Dunn, Shannon E. MPH, MSW; An, Lawrence C. MD; Stanton, Cassandra A. PhD

JAIDS Journal of Acquired Immune Deficiency Syndromes: 1 September 2014 - Volume 67 - Issue 1 - p 59–66
doi: 10.1097/QAI.0000000000000226
Clinical Science

Objective: To evaluate the feasibility and preliminary efficacy of a Web-based tobacco treatment for persons living with HIV (PLWH).

Design: Prospective, randomized controlled trial.

Setting: HIV-care center in the Bronx, New York.

Subjects: Eligibility criteria included HIV infection, current tobacco usage, interest in quitting, and access to a computer with internet. One hundred thirty-eight subjects enrolled, and 134 completed the study.

Intervention: Positively Smoke Free on the Web (PSFW), an 8-session, 7-week targeted tobacco treatment program for PLWH, was compared with standard care (brief advice to quit and self-help brochure). All subjects were offered nicotine patches.

Main Outcome Measures: The main feasibility outcomes were number of sessions logged into, number of Web pages visited, number of interactive clicks, and total time logged in. The main efficacy outcome was biochemically verified, 7-day point prevalence abstinence 3 months after intervention.

Results: PSFW subjects logged into a mean of 5.5 of 8 sessions and 26.2 of 41 pages. They executed a mean of 10 interactive clicks during a mean total of 59.8 minutes logged in. Most required reminder phone calls to complete the sessions. Educational level, anxiety score, and home access of the Web site were associated with Web site usage. Ten percent of the PSFW group vs. 4.3% of controls achieved the abstinence end point. Among those who completed all 8 sessions, 17.9% were abstinent, and among women completers, 30.8% were abstinent.

Conclusions: Web-based treatment is a feasible strategy for PLWH smokers, and preliminary findings suggest therapeutic efficacy.

*Department of Medicine, AIDS Center/Division of Infectious Diseases, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY;

Department of Medicine, Center for Health Communications Research, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; and

Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC.

Correspondence to: Jonathan Shuter, MD, Montefiore Medical Center AIDS Center, 111 E 210th Street, Bronx, NY 10467 (e-mail: jshuter@montefiore.org).

Supported by Grants R21CA163100-01 and P30CA051008 from the National Institutes of Health/National Cancer Institute. Also supported by the Clinical Core of the Center for AIDS Research at the Albert Einstein College of Medicine and Montefiore Medical Center funded by the National Institutes of Health (NIH AI-51519).

This trial is registered with clinicaltrials.gov, trial number NCT01570595.

Presented in part at the 20th Annual Meeting of the Society for Research on Nicotine and Tobacco, February 5–8, 2014, Seattle, WA.

The authors have no conflicts of interest to disclose.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.

Received March 14, 2014

Accepted May 05, 2014

© 2014 by Lippincott Williams & Wilkins