Outcome of smoking cessation counselling of HIV‐positive persons by HIV care physicians

Abstract

Objectives Smoking is the most prevalent modifiable risk factor for cardiovascular diseases among HIV‐positive persons. We assessed the effect on smoking cessation of training HIV care physicians in counselling. Methods The Swiss HIV Cohort Study (SHCS) is a multicentre prospective observational database. Our single‐centre intervention at the Zurich centre included a half day of standardized training for physicians in counselling and in the pharmacotherapy of smokers, and a physicians' checklist for semi‐annual documentation of their counselling. Smoking status was then compared between participants at the Zurich centre and other institutions. We used marginal logistic regression models with exchangeable correlation structure and robust standard errors to estimate the odds of smoking cessation and relapse. Results Between April 2000 and December 2010, 11 056 SHCS participants had 121 238 semi‐annual visits and 64 118 person‐years of follow‐up. The prevalence of smoking decreased from 60 to 43%. During the intervention at the Zurich centre from November 2007 to December 2009, 1689 participants in this centre had 6068 cohort visits. These participants were more likely to stop smoking [odds ratio (OR) 1.23; 95% confidence interval (CI) 1.07–1.42; P = 0.004] and had fewer relapses (OR 0.75; 95% CI 0.61–0.92; P = 0.007) than participants at other SHCS institutions. The effect of the intervention was stronger than the calendar time effect (OR 1.19 vs. 1.04 per year, respectively). Middle‐aged participants, injecting drug users, and participants with psychiatric problems or with higher alcohol consumption were less likely to stop smoking, whereas persons with a prior cardiovascular event were more likely to stop smoking. Conclusions An institution‐wide training programme for HIV care physicians in smoking cessation counselling led to increased smoking cessation and fewer relapses.

Smoking Cessation for People Living With HIV/AIDS: A Literature Review and Synthesis

“…In one study, one center from the Swiss HIV Cohort Study implemented a structured smoking cessation training program for medical staff. 46 All physicians participated in a half-day workshop on treatment for nicotine dependence. Subsequently, all patients underwent assessment and treatment for smoking at their semiannual appointments.…”

Research Priorities for Article 14--Demand Reduction Measures Concerning Tobacco Dependence and Cessation

“…For example, there are opportunities, and a need (Drach et al, 2010), to integrate TDT into HIV/AIDS treatment programs, and although there are data showing that this can be done in traditional health care settings (Huber et al, 2012), there is a paucity of data exploring integration into non-health care settings. Similarly work has been undertaken to assess the feasibility and effectiveness of including TDT into TB clinics (World Health Organization, 2007), and guidelines based around the ABC approach for smoking cessation (McRobbie, Bullen, et al, 2008) have been produced by the International Union Against Tuberculosis and Lung Disease (Bissell, Fraser, Chiang, & Enarson, 2010).…”

Perceptions Regarding Medical Management of Clubfoot in Kenya

“…Counselling entails talking with a person in a manner that helps one sort out issues or that helps to create circumstances that will assist one to understand and/or improve his behaviour, character, values or life circumstances (Huber et al, 2012;Ding et al, 2012;Zimmermann, Thompson & Persell, 2012). All the service providers were in consensus that the parents/caregivers needed counselling prior to commencement of treatment.…”

“…This can only be achieved by bringing the parents/caregivers on board through counselling and education (Huber et al, 2012;Ding et al, 2012). A study by Scott and Evans (1997) on clubfoot management in Tanzania found that most 77 of the children with clubfoot that were treated using the Ponseti management were lost to followup before achieving satisfactory results.…”