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. 2021 Nov;35(7):788-796.
doi: 10.1037/adb0000619. Epub 2020 Jul 20.

Patterns of lapses and recoveries during a quit attempt using varenicline and behavioral counseling among smokers with and without HIV

Rebecca L Ashare  1 , E Paul Wileyto  2 , Erin Logue-Chamberlain  1 , Robert Gross  3 , Rachel F Tyndale  4 , Caryn Lerman  5 , Larry W Hawk  6 , Paul Cinciripini  7 , Tony P George  8 , Su Fen Lubitz  1 , Robert Schnoll  1
Affiliations

Patterns of lapses and recoveries during a quit attempt using varenicline and behavioral counseling among smokers with and without HIV

Rebecca L Ashare et al. Psychol Addict Behav. 2021 Nov.

Abstract

Addressing tobacco use among HIV+ smokers is a priority. Lack of knowledge about how HIV+ smokers respond to tobacco use treatments limits our ability to effectively treat this population of smokers. Using data from 2 clinical trials that provided 12 weeks of varenicline and behavioral counseling, 1 with smokers with HIV (n = 89) and 1 with smokers without HIV (n = 179), we used mixed logistic regression modeling to compare point-prevalence abstinence rates and adherence to the initial target quit date (TQD) and Cox regression for repeated outcomes to evaluate lapse and recovery dynamics between the groups. Sixty percent of HIV- smokers refrained from smoking at the TQD while only 33% of HIV+ smokers did (odds ratio [OR] = 0.32, 95% CI [0.18, 0.56], p < .001). The point-prevalence abstinence rates at Week 12 were 31% (HIV-) and 28% (HIV+; OR = 0.7, 95% CI [0.42, 1.16], p = .16) and the point prevalence abstinence rates at Week 24 were 22% (HIV-) and 15% (HIV+; OR = 0.87, 95% CI [0.49, 1.57], p = .65). Although there was no interaction between HIV status and lapse risk, χ2(3) < 1, there was a significant interaction for the recovery model, (χ2(3) = 20.4, p < 0.001): as the number of events increased, the time to the next recovery became longer among smokers with HIV, compared to smokers without HIV. Although HIV+ smokers were treated effectively with varenicline, compared to HIV- smokers, they showed significantly lower initial cessation at the TQD and took increasingly longer to recover following lapses. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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Figures

Figure 1.
Figure 1.
Sample patterns of smoking behavior for two subjects. (A) A subject who had an early lapse event (t1), recovered relatively quickly (t2), and remained abstinent through the end of treatment (t3). (B) A subject who had 5 lapses of varying duration with brief recoveries in between until ultimately relapsing prior to Day 40. This subject was still smoking at EOT.
Figure 2.
Figure 2.
Frequency distribution for the number of lapse events among subjects.
See this image and copyright information in PMC

References

    1. Altekruse SF, Shiels MS, Modur SP, Land SR, Crothers KA, Kitahata MM, … Engels EA (2018). Cancer burden attributable to cigarette smoking among HIV-infected people in North America. AIDS, 32(4), 513–521. doi:10.1097/QAD.0000000000001721 - DOI - PMC - PubMed
    1. Antiretroviral Therapy Cohort, C. (2008). Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies. Lancet, 372(9635), 293–299. doi:10.1016/S0140-6736(08)61113-7 - DOI - PMC - PubMed
    1. Ashare RL, Thompson M, Leone F, Metzger D, Gross R, Mounzer K, … Schnoll R (2019). Differences in the rate of nicotine metabolism among smokers with and without HIV. AIDS, 33(6), 1083–1088. doi:10.1097/qad.0000000000002127 - DOI - PMC - PubMed
    1. Ashare RL, Thompson M, Serrano K, Leone F, Metzger D, Frank I, … Schnoll (2019). Placebo-controlled randomized clinical trial testing the efficacy and safety of varenicline for smokers with HIV. Drug Alcohol Depend, 200, 26–33. doi:10.1016/j.drugalcdep.2019.03.011 - DOI - PMC - PubMed
    1. Ashare RL, Wileyto EP, Perkins KA, & Schnoll RA (2013). The first 7 days of a quit attempt predicts relapse: validation of a measure for screening medications for nicotine dependence. J Addict Med, 7(4), 249–254. doi:10.1097/ADM.0b013e31829363e1 - DOI - PMC - PubMed