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Renukuntla J, Peterson-Sockwell S, Clark BA, Godage NH, Gionfriddo E, Bolla PK, Boddu SHS. Design and Preclinical Evaluation of Nicotine-Stearic Acid Conjugate-Loaded Solid Lipid Nanoparticles for Transdermal Delivery: A Technical Note. Pharmaceutics 2023; 15:pharmaceutics15041043. [PMID: 37111529 PMCID: PMC10146358 DOI: 10.3390/pharmaceutics15041043] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/09/2023] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
This study aimed to develop and evaluate nicotine--stearic acid conjugate-loaded solid lipid nanoparticles (NSA-SLNs) for transdermal delivery in nicotine replacement therapy (NRT). Nicotine conjugation to stearic acid prior to SLN formulation greatly increased drug loading. SLNs loaded with a nicotine-stearic acid conjugate were characterized for size, polydispersity index (PDI), zeta potential (ZP), entrapment efficiency, and morphology. Pilot in vivo testing was carried out in New Zealand Albino rabbits. The size, PDI, and ZP of nicotine-stearic acid conjugate-loaded SLNs were 113.5 ± 0.91 nm, 0.211 ± 0.01, and -48.1 ± 5.75 mV, respectively. The entrapment efficiency of nicotine-stearic acid conjugate in SLNs was 46.45 ± 1.53%. TEM images revealed that optimized nicotine-stearic acid conjugate-loaded SLNs were uniform and roughly spherical in shape. Nicotine-stearic acid conjugate-loaded SLNs showed enhanced and sustained drug levels for up to 96 h in rabbits when compared with the control nicotine formulation in 2% HPMC gel. To conclude, the reported NSA-SLNs could be further explored as an alternative for treating smoking cessation.
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Affiliation(s)
- Jwala Renukuntla
- School of Pharmacy, The University of Texas at El Paso, 1101 N Campbell St., El Paso, TX 79902, USA
- Department of Basic Pharmaceutical Sciences, Fred Wilson School of Pharmacy, High Point University, High Point, NC 27240, USA
| | - Samuel Peterson-Sockwell
- Department of Basic Pharmaceutical Sciences, Fred Wilson School of Pharmacy, High Point University, High Point, NC 27240, USA
| | - Bradley A Clark
- Department of Basic Pharmaceutical Sciences, Fred Wilson School of Pharmacy, High Point University, High Point, NC 27240, USA
| | - Nipunika H Godage
- Department of Chemistry and Biochemistry, School of Green Chemistry and Engineering, College of Natural Sciences and Mathematics, University of Toledo, Toledo, OH 43606, USA
| | - Emanuela Gionfriddo
- Department of Chemistry and Biochemistry, School of Green Chemistry and Engineering, College of Natural Sciences and Mathematics, University of Toledo, Toledo, OH 43606, USA
| | - Pradeep Kumar Bolla
- School of Pharmacy, The University of Texas at El Paso, 1101 N Campbell St., El Paso, TX 79902, USA
| | - Sai H S Boddu
- College of Pharmacy and Health Sciences, Ajman University, Ajman P.O. Box 346, United Arab Emirates
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman P.O. Box 346, United Arab Emirates
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Gajos JM, Hawes ES, Chana SM, Mrug S, Wolford-Clevenger C, Businelle MS, Carpenter MJ, Cropsey KL. Daily adherence to nicotine replacement therapy in low-income smokers: The role of gender, negative mood, motivation, and self-efficacy. Addict Behav 2023; 138:107543. [PMID: 36423571 PMCID: PMC9780181 DOI: 10.1016/j.addbeh.2022.107543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Low-income smokers may benefit from interventions promoting nicotine replacement therapies (NRTs), particularly for women, as women have worse smoking cessation outcomes than men. Little is known about factors that affect daily NRT adherence, such as negative mood, motivation, and self-efficacy, and whether gender moderates these associations. METHODS Secondary analysis of a randomized controlled trial comparing a novel, in session sampling of short-acting combination NRT intervention (In Vivo) to standard care smoking cessation behavioral counseling was performed. Low-income smokers (n = 62; Mage = 47.4; 42 % female; 61 % non-White) completed daily surveys using the Insight™ mHealth platform for 55 consecutive days. Three types of NRT adherence were examined: dose amount of short-acting NRT, nicotine patch wear time, and combination NRT (cNRT) (combined nicotine patch and short-acting NRT). RESULTS Generalized multilevel models report same-day negative mood was associated with greater likelihood of nicotine patch adherence in men, but unrelated to women's nicotine patch adherence. Same-day negative mood was associated with greater likelihood of cNRT adherence in men, but less likelihood in women. The relationship between same-day motivation and use of short-acting NRT varied by gender, but simple slope analyses revealed that motivation was unrelated to short-acting NRT use within either group. Same-day self-efficacy was related to an increased likelihood of nicotine patch adherence and cNRT adherence in women but unrelated to men's adherence of either type. CONCLUSIONS Future research should focus on gender differences in low-income smokers' same-day negative mood, motivation, and self-efficacy processes on NRT adherence during smoking cessation interventions.
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Affiliation(s)
- Jamie M Gajos
- University of Alabama at Birmingham, Department of Family and Community Medicine, 930 20th Street South, Birmingham, AL 35205, USA
| | - Elizabeth S Hawes
- University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, 1670 University Blvd, Birmingham, AL 35233, USA
| | - Sofía Mildrum Chana
- University of Alabama at Birmingham, Department of Psychology, 1720 2nd Avenue South, Birmingham, AL 35294, USA
| | - Sylvie Mrug
- University of Alabama at Birmingham, Department of Psychology, 1720 2nd Avenue South, Birmingham, AL 35294, USA
| | - Caitlin Wolford-Clevenger
- University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, 1670 University Blvd, Birmingham, AL 35233, USA
| | - Michael S Businelle
- University of Oklahoma Health Sciences Center, Health Promotion Research Center, Stephenson Cancer Center, 655 Research Parkway, Oklahoma City, OK 73104, USA
| | - Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina (MUSC), Hollings Cancer Center, MUSC, Charleston, SC, USA
| | - Karen L Cropsey
- University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, 1670 University Blvd, Birmingham, AL 35233, USA.
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Cartujano-Barrera F, Lee D’Abundo M, Arana-Chicas E, Chock S, Valera P, Kamen CS, Cupertino AP. Barriers and Facilitators of Smoking Cessation among Latinos Living with HIV: Perspectives from Key Leaders of Community-Based Organizations and Clinics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073437. [PMID: 33810269 PMCID: PMC8036939 DOI: 10.3390/ijerph18073437] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/17/2021] [Accepted: 03/24/2021] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to identify the perspectives from key leaders of community-based organizations (CBOs) and clinics serving people living with HIV on barriers and facilitators of smoking cessation among Latino smokers living with HIV. Semi-structured interviews were conducted in English and Spanish with 10 key leaders. Using a social ecological model, qualitative theoretical analysis was used to analyze the results. Participants identified barriers at the individual (e.g., low education level, HIV, and financial stress), interpersonal (e.g., language barriers, low social support), organizational (e.g., lack of smoking cessation resources and targeted interventions), community (e.g., HIV and mental health stigma), and policy (e.g., paperwork for insurance) level. Participants identified facilitators at the individual (e.g., high participation in trials, good medication adherence), interpersonal (e.g., no smoking in social circles), organizational (e.g., bilingual staff, culturally competent care), community (e.g., providing transportation, the coronavirus disease 2019 as an opportunity for smoking cessation), and policy level (e.g., existence of funding, comprehensive insurance programs). These results provide operational strategies to address smoking disparities among Latino smokers living with HIV. Further research is needed on how to integrate these perspectives into effective smoking cessation interventions.
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Affiliation(s)
- Francisco Cartujano-Barrera
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (S.C.); (C.S.K.); (A.P.C.)
- Correspondence: ; Tel.: +1-585-353-0035
| | - Michelle Lee D’Abundo
- Department of Interprofessional Health Sciences and Health Administration, Seton Hall University, Nutley, NJ 07110, USA;
| | - Evelyn Arana-Chicas
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (S.C.); (C.S.K.); (A.P.C.)
| | - Surina Chock
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (S.C.); (C.S.K.); (A.P.C.)
| | - Pamela Valera
- Department of Urban-Global Public Health, Rutgers University, Newark, NJ 07102, USA;
| | - Charles S. Kamen
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (S.C.); (C.S.K.); (A.P.C.)
| | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (S.C.); (C.S.K.); (A.P.C.)
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Mersha AG, Gould GS, Bovill M, Eftekhari P. Barriers and Facilitators of Adherence to Nicotine Replacement Therapy: A Systematic Review and Analysis Using the Capability, Opportunity, Motivation, and Behaviour (COM-B) Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8895. [PMID: 33265956 PMCID: PMC7731205 DOI: 10.3390/ijerph17238895] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/26/2020] [Accepted: 11/27/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Poor adherence to nicotine replacement therapy (NRT) is associated with low rates of smoking cessation. Hence, this study aims to identify and map patient-related factors associated with adherence to NRT using the capability, opportunity, motivation, and behaviour (COM-B) model. METHODS A systematic review was conducted by searching five databases (MEDLINE, Scopus, EMBASE, CINAHL, and PsycINFO) and grey literature on 30 August 2020. Data were extracted, thematically analysed, and mapped to the COM-B model. The Joanna Briggs Institute (JBI) critical appraisal tool was utilised to assess the quality of studies. RESULTS A total of 2929 citations were screened, and 26 articles with a total of 13,429 participants included. Thirty-one factors were identified and mapped to COM-B model: psychological capability (forgetfulness, education), physical capability (level of nicotine dependence, withdrawal symptoms), reflective motivation (perception about NRT and quitting), automatic motivation (alcohol use, stress, depression), physical opportunity (cost), and social opportunity (social support). The most prominent element associated with adherence was reflective motivation followed by physical capability and automatic motivation. CONCLUSIONS Multiple personal, social, and environmental factors affect NRT adherence. Hence, it is recommended to implement a multifaceted behavioural intervention incorporating factors categorised under the COM-B model, which is the hub of the behaviour change wheel (BCW) to improve adherence and quitting.
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Affiliation(s)
- Amanual Getnet Mersha
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (G.S.G.); (M.B.); (P.E.)
| | - Gillian Sandra Gould
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (G.S.G.); (M.B.); (P.E.)
- Hunter Medical Research Institute, Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Michelle Bovill
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (G.S.G.); (M.B.); (P.E.)
- Hunter Medical Research Institute, Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Parivash Eftekhari
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (G.S.G.); (M.B.); (P.E.)
- Hunter Medical Research Institute, Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
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Mann-Jackson L, Choi D, Sutfin EL, Song EY, Foley KL, Wilkin AM, Morse CG, Rojas NF, Oh TS, Rhodes SD. A Qualitative Systematic Review of Cigarette Smoking Cessation Interventions for Persons Living with HIV. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:1045-1058. [PMID: 31037506 PMCID: PMC6819245 DOI: 10.1007/s13187-019-01525-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Persons living with HIV (PLWH) have disproportionately high rates of both cigarette smoking and tobacco-induced negative health outcomes. The goal of this qualitative systematic review was to identify gaps in the existing literature and future directions for smoking cessation support for PLWH. Three online databases were searched from their inception through December 31, 2017, using designated search terms. Peer-reviewed English-language articles that documented an intervention designed to increase smoking cessation among PLWH were reviewed. Data were abstracted using a standardized form to document study and intervention characteristics and results. Thirty-two articles, describing 28 unique intervention studies, met inclusion criteria. Interventions consisted primarily of combinations of counseling, pharmacotherapy, and the use of information and communications technology; few interventions were implemented at the clinic level. Thirteen interventions resulted in significant improvements in cessation-related outcomes. Information and communications technology and clinic-level interventions had the greatest potential for increasing smoking cessation among PLWH. Efficacious interventions designed for PLWH in the US South, and for groups of PLWH facing additional health disparities (e.g., communities of color and sexual and gender minorities), are needed. There is also a need for more rigorous research designs to test the efficacy of interventions designed to increase cessation-related outcomes among PLWH.
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Affiliation(s)
- Lilli Mann-Jackson
- Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
- Wake Forest Clinical and Translational Science Institute Program in Community Engagement, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
| | - David Choi
- Stanford University, 401 Quarry Road, Palo Alto, CA, 94304, USA
| | - Erin L Sutfin
- Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Eunyoung Y Song
- Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Kristie L Foley
- Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Aimee M Wilkin
- Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Caryn G Morse
- Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Nicole F Rojas
- Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Timothy S Oh
- Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Scott D Rhodes
- Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
- Wake Forest Clinical and Translational Science Institute Program in Community Engagement, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
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Kim N, McCarthy DE, Loh WY, Cook JW, Piper ME, Schlam TR, Baker TB. Predictors of adherence to nicotine replacement therapy: Machine learning evidence that perceived need predicts medication use. Drug Alcohol Depend 2019; 205:107668. [PMID: 31707266 PMCID: PMC6931262 DOI: 10.1016/j.drugalcdep.2019.107668] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 09/18/2019] [Accepted: 09/25/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Nonadherence to smoking cessation medication is a frequent problem. Identifying pre-quit predictors of nonadherence may help explain nonadherence and suggest tailored interventions to address it. AIMS Identify and characterize subgroups of smokers based on adherence to nicotine replacement therapy (NRT). METHOD Secondary classification tree analyses of data from a 2-arm randomized controlled trial of Recommended Usual Care (R-UC, n = 315) versus Abstinence-Optimized Treatment (A-OT, n = 308) were conducted. R-UC comprised 8 weeks of nicotine patch plus brief counseling whereas A-OT comprised 3 weeks of pre-quit mini-lozenges, 26 weeks of nicotine patch plus mini-lozenges, 11 counseling contacts, and 7-11 automated reminders to use medication. Analyses identified subgroups of smokers highly adherent to nicotine patch use in both treatment conditions, and identified subgroups of A-OT participants highly adherent to mini-lozenges. RESULTS Varied facets of nicotine dependence predicted adherence across treatment conditions 4 weeks post-quit and between 4- and 16-weeks post-quit in A-OT, with greater baseline dependence and greater smoking trigger exposure and reactivity predicting greater medication use. Greater quitting motivation and confidence, and believing that stop smoking medication was safe and easy to use were associated with greater adherence. CONCLUSION Adherence was especially high in those who were more dependent and more exposed to smoking triggers. Quitting motivation and confidence predicted greater adherence, while negative beliefs about medication safety and acceptability predicted worse adherence. Results suggest that adherent use of medication may reflect a rational appraisal of the likelihood that one will need medication and will benefit from it.
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Affiliation(s)
- Nayoung Kim
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI 53711, USA.
| | - Danielle E McCarthy
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI 53711, USA
| | - Wei-Yin Loh
- Department of Statistics, University of Wisconsin, Madison, WI 53706, USA
| | - Jessica W Cook
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI 53711, USA
| | - Megan E Piper
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI 53711, USA
| | - Tanya R Schlam
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI 53711, USA
| | - Timothy B Baker
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI 53711, USA
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Pacek LR, McClernon FJ, Bosworth HB. Adherence to Pharmacological Smoking Cessation Interventions: A Literature Review and Synthesis of Correlates and Barriers. Nicotine Tob Res 2018; 20:1163-1172. [PMID: 29059394 PMCID: PMC6121917 DOI: 10.1093/ntr/ntx210] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 09/15/2017] [Indexed: 01/09/2023]
Abstract
Introduction Efficacious pharmacological interventions for smoking cessation are available, but poor adherence to these treatments may limit these interventions overall impact. To improve adherence to smoking cessation interventions, it is first necessary to identify and understand smoker-level characteristics that drive nonadherence (ie, nonconformance with a provider's recommendation of timing, dosage, or frequency of medication-taking during the prescribed length of time). Methods We present a literature review of studies examining correlates of, or self-reported reasons for, nonadherence to smoking cessation pharmacotherapies. Studies were identified through PubMed-using MeSH terms, Embase-using Emtree terms, and ISI Web of Science. Results and Conclusions This literature review included 50 studies that examined nonpreventable (eg, sociodemographics) and preventable (eg, forgetfulness) factors associated with adherence to smoking cessation medication and suggestions for overcoming some of the identified barriers. Systematic study of this topic would be facilitated by consistent reporting of adherence and correlates thereof in the literature, development of consistent definitions of medication adherence across studies, utilization of more objective measures of adherence (eg, blood plasma levels vs. self-report) in addition to reliance on self-reported adherence. Implications This article provides the most comprehensive review to date on correlates of adherence to pharmacological smoking cessation interventions. Challenges and specific gaps in the literature that should be a priority for future research are discussed. Future priorities include additional research, particularly among vulnerable populations of smokers, developing standardized definitions of adherence and methods for measuring adherence, regular assessment of cessation pharmacotherapy adherence in the context of research and clinical practice, and development of novel treatments aimed at preventable barriers to medication adherence.
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Affiliation(s)
- Lauren R Pacek
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - F Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Hayden B Bosworth
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
- Department of Medicine, Division of General Medicine, Duke University School of Medicine, Durham, NC
- Center for Health Services Research in Primary Care, Durham VAMC, Durham, NC
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Tucker JS, Shadel WG, Galvan FH, Naranjo D, Lopez C, Setodji C. Pilot evaluation of a brief intervention to improve nicotine patch adherence among smokers living with HIV/AIDS. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2016; 31:148-153. [PMID: 27736144 DOI: 10.1037/adb0000221] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Nicotine replacement therapy is an effective intervention for smoking cessation, but adherence tends to be low. This article presents results from a pilot evaluation of a brief smoking cessation treatment to improve adherence to the nicotine patch among Latino smokers living with HIV/AIDS. Forty smokers were randomized to receive either a standard 5 As counseling session and 8-week treatment of nicotine patch, or a similar intervention that added a 10-min module to the 5 As counseling that focused on improving adherence to the nicotine patch. Smoking outcomes (breath carbon monoxide monitoring verified 7-day point prevalence and continuous abstinence) were evaluated through a 3-month follow-up. Patch usage during the follow-up period was also assessed. Intention to treat analyses indicated that abstinence rates were 2 to 3 times higher in the adherence condition compared with the standard condition (7-day point prevalence abstinence: 35.0% vs. 15.0%; continuous abstinence: 30.0% vs. 10.0%). Nicotine patch compliance over an 8-week period was also higher in the adherence condition than in the standard condition (44% vs. 25%). Although this small pilot was conducted to estimate effect sizes and was not powered to detect group differences, results are promising and suggest that adding a 10-min module focused on nicotine patch adherence to a standard 5 As protocol can increase abstinence rates. Given that this smoking cessation treatment was not specifically tailored to either HIV-positive smokers or Latino smokers, future research should examine whether it may be a promising approach for improving nicotine patch adherence in the general population of smokers. (PsycINFO Database Record
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