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. 2020 Mar:102:106151.
doi: 10.1016/j.addbeh.2019.106151. Epub 2019 Oct 22.

Correlates of varenicline adherence among smokers with HIV and its association with smoking cessation

Mackenzie Hosie Quinn  1 , Anna-Marika Bauer  1 , Alex Flitter  1 , Su Fen Lubitz  1 , Rebecca L Ashare  1 , Morgan Thompson  1 , Frank Leone  2 , Robert Gross  3 , Robert Schnoll  4
Affiliations

Correlates of varenicline adherence among smokers with HIV and its association with smoking cessation

Mackenzie Hosie Quinn et al. Addict Behav. 2020 Mar.

Abstract

Introduction: With medical advances, the life expectancy of people living with HIV/AIDS (PLWHA) has improved; however, tobacco use remains a prominent risk for mortality. Although studies have examined the efficacy of varenicline for treating smoking among PLWHA, the relationship between varenicline adherence and cessation and correlates of varenicline adherence remain under-studied.

Methods: We conducted secondary analyses from a randomized placebo-controlled trial of varenicline for smoking among PLWHA, using data from participants who received varenicline (N = 89). The relationship between varenicline adherence (based on pill count) and end-of-treatment smoking cessation was assessed, as were correlates of varenicline adherence.

Results: Those who were abstinent took an average of 137.1 pills (SD = 39.3), or 83% of pills prescribed, vs. 105.3 pills (SD = 64.1), or 64%, for those who were smoking (OR = 1.01, 95% CI: 1.001-1.021, p = 0.03); 52/89 (58%) participants were adherent based on taking ≥80% of pills. The quit rate for adherent participants was 35% (18/52) vs. 19% (7/37) for non-adherent participants. Adherent participants were older, smoked fewer cigarettes each day, started smoking at an older age, and had lower baseline creatinine vs. non-adherent participants (p < 0.05). There was a significant time-by-group interaction effect for anxiety (F[1,72] = 6.24, p = 0.02), depression (F[1,72] = 4.2, p = 0.04), and insomnia (F[1,72] = 7.73, p = 0.007), indicating that adherent participants had less depression, anxiety, and insomnia during the initial weeks of treatment, vs. non-adherent participants.

Conclusions: Our findings underscore the importance of varenicline adherence for determining cessation and highlight the role of early changes in anxiety, depression, and insomnia determining varenicline adherence.

Keywords: Adherence; Anxiety; Depression; HIV; Smoking cessation; Varenicline.

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Conflict of interest statement

Conflicts of Interest

Dr. Schnoll receives medication and placebo free from Pfizer and has provided consultation to Pfizer. Dr. Schnoll has provided consultation to GlaxoSmithKline and CuraLeaf. Dr. Gross serves on a Data and Safety Monitoring Board for a Pfizer drug unrelated to HIV or smoking.

Figures

Figure 1.
Figure 1.
Changes in Anxiety and Depression Symptoms and Insomnia between Adherent and Non-Adherent Participants
See this image and copyright information in PMC

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