An HIV-tailored quit-smoking counselling pilot intervention targeting depressive symptoms plus Nicotine Replacement Therapy
An HIV-tailored quit-smoking counselling pilot intervention targeting depressive symptoms plus Nicotine Replacement Therapy
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DOI：
10.1080/09540121.2016.1201195
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发表时间：
2017-01-01
影响因子：
1.7
通讯作者：
MacPherson, Paul A.
中科院分区：
文献类型：
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作者：
Balfour, Louise;Wiebe, Stephanie A.;MacPherson, Paul A.
艾滋病毒/艾滋病（PHA）感染者的心血管疾病（CVD）发病率很高。吸烟率是PHA中CVD的主要贡献者，为40-70%（比一般人群高2-3倍）。此外，PHAs有很高的抑郁率（40-60%），这是戒烟复发的风险因素。目前的试点研究检查了一个专门为PHA量身定制的5次戒烟咨询计划的有效性，该计划针对抑郁症，与尼古丁替代疗法（NRT）相结合，在PHA吸烟者队列（n = 50）中。在6个月的随访中，28%的参与者表现出经生化证实的戒烟。这一结果优于其他戒烟干预研究，特别是考虑到患有抑郁症的艾滋病毒+吸烟者的比例很高。在研究基线时，52%的HIV+吸烟者在流行病学研究中心-抑郁症（CES-D）量表上的得分高于抑郁症的临床截止值。在研究基线时患有抑郁症的HIV+吸烟者在6个月随访时表现出较低的抑郁症，效应量较大（d = 1），尽管没有达到统计学显著性（p= 0.058）。此外，抑郁症患者复发的可能性并不比没有抑郁症的患者高（p= 0.33），这表明我们的咨询计划充分解决了PHAs中戒烟的这一重大障碍。我们的试点研究表明，量身定制的方案，以帮助PHAs戒烟的重要性，解决抑郁症状的意义，以及需要量身定制的咨询方案，以提高PHAs之间的戒烟率。
Cardiovascular disease (CVD) rates among people living with HIV/AIDS (PHAs) are high. Rates of cigarette smoking, a leading contributor to CVD among PHAs, are 40-70% (2-3 times higher than the general population). Furthermore, PHAs have high rates of depression (40-60%), a risk factor for smoking cessation relapse. The current pilot study examined the effectiveness of a specifically tailored 5-session smoking cessation counselling programme for PHAs, which addressed depression, in combination with Nicotine Replacement Therapy (NRT) in a cohort of PHA smokers (n = 50). At 6-month follow-up, 28% of participants demonstrated biochemically verified abstinence from smoking. This result compares favourably to other quit-smoking intervention studies, particularly given the high percentage of HIV+ smokers with depression. At study baseline, 52% of HIV+ smokers scored above the clinical cut-off for depression on the Centre for Epidemiological Studies - Depression (CES-D) scale. HIV+ smokers with depression at study baseline demonstrated quantitatively lower depression at 6-month follow-up with a large effect size (d = 1), though it did not reach statistical significance (p=.058). Furthermore, those with depression were no more likely to relapse than those without depression (p=.33), suggesting that our counselling programme adequately addressed this significant barrier to smoking cessation among PHAs. Our pilot study indicates the importance of tailored programmes to help PHAs quit smoking, the significance of addressing depressive symptoms, and the need for tailored counselling programmes to enhance quit rates among PHAs.