Methods: Participants were PLWH attending our clinic and smoking at least 5 cigarettes/day regardless of their motivation to quit (N=60). Each participant had an initial visit and 2 phone visits (+1 and +3 months). Participants completed surveys via computer during the first visit and by phone in the follow-ups. Additional clinical data was collected via chart review.
Results: Participants had a mean age of 48, were mostly African-American(72%) and male(67%) with well controlled HIV (mean CD4 622, undetectable viral load in 70%). The mean AUDIT score to assess for alcohol abuse did not change over the 3 time points (7.1;7.2;7.6, median 4;5;5). A score of 8 or higher indicates harmful alcohol consumption and 23% of patients met the criteria. Lifetime self-reported treatment for substance abuse was high (35%). DAST score for assessing substance abuse was used and mean scores decreased slightly over time (2.3;1.2;0.93, median 2;0;0). A score of 6 or higher indicates a substance use disorder and 15% met that criteria at baseline, 3% at 3 months. Chart review had similar results with 18% having a diagnosis of substance abuse and 20% with alcohol abuse. Overall participants (n=60) showed a decrease in tobacco use, with an average of 14 cigarettes/day at baseline and 7 cigarettes/day at 3 months (p=0.001). Patients with a diagnosis of substance abuse had a baseline average of 12 cigarettes/day and 6 cigarettes/day at 3 months (reduction 6). For those with an alcohol abuse diagnosis, baseline was 16 cigarettes/day and at 3 months, 10 cigarettes/day (reduction 6). The change over time was not significantly different between the groups.
Conclusion: People living with HIV who smoke are a complex group of patients who commonly have concurrent or historical substance and alcohol abuse. A substance and alcohol abuse diagnosis did not impact the decrease in tobacco use seen with implementation of a decisional algorithm.
M. C. Bean,