Montefiore Medical Center researchers have received a $3.7 million grant from the National Institute on Drug Abuse at the National Institutes of Health (NIH) to develop an anti-smoking program for HIV-infected smokers. The five-year grant supports the study of Positively Smoke Free (PSF), an intensive group cessation program designed specifically for HIV-infected smokers.
The PSF program uses cognitive behavioral therapy and includes eight 90-minute sessions for groups of six to eight people led by a psychologist and HIV-infected peer. In the original pilot study of 145 patients, 19.2 percent quit smoking vs. 9.7 percent in the control group. Since quit rates almost doubled with the PSF program, NIH recognized the promise of the program and awarded a larger grant.
"Approximately 60 percent of individuals living with HIV in the United States are smokers, which is triple the national average, and the majority are interested in quitting," said Jonathan Shuter, M.D., director of clinical research, Montefiore AIDS Center and professor of Clinical Medicine, Albert Einstein College of Medicine of Yeshiva University. "However, there are unique psychosocial characteristics among many HIV-infected smokers who are not effectively reached through traditional smoking cessation programs."
The randomized trial will investigate the efficacy of PSF compared with the current standard of care, which consists of brief advice about quitting smoking during a patient's regular office visit. The study also will assess specific behaviors that may be linked to successful cessation among HIV-infected smokers. The goal is to enroll 450 patients during the next three and a half years. Abstinence from cigarettes will be followed for six months after the end of the sessions. Their refrain from smoking will be confirmed with exhaled carbon monoxide.
"I lead the development of this trial because new treatments have improved AIDS outcomes and, now my patients are dying of heart disease, strokes and lung cancer, which are often associated with smoking" said Dr. Shuter. "When your life is complicated by health, social and environmental stressors and when you live in a community where it is common to smoke, you need added support and education to help you stop."
In addition to two sites at Montefiore, 100 patients will be enrolled at Georgetown University.
Helping people achieve their goal of reducing tobacco use has been one of Montefiore's key focus areas. In addition to many services and support provided to staff and patients, Montefiore also has made all campuses completely smoke-free.
Montefiore Medical Center