Yale University
Cigarette smoking is an important cause of illness and death among persons with HIV (PWH). This project will study the impact of adding contingency management (use of financial rewards) to receiving medications and counseling on promoting smoking abstinence and other health outcomes among PWH. As treatments will be provided by clinical pharmacists and other team members in HIV clinics, factors relevant for implementing this model to inform real-world practice will also be evaluated.
Cigarette smoking is a major threat to health among persons with HIV (PWH). Via direct effects and link with TUD-related conditions (behaviors and medical conditions that drive poor outcomes), smoking causes more lost life years than treated HIV. Cardiovascular disease, lung disease, and cancer are indeed leading causes of death among PWH. Guidelines recommend medications for TUD (MTUD) and behavioral interventions to promote smoking cessation. Data also support use of contingency management (CM) to target smoking cessation and treatment adherence. Yet, adoption of these approaches in HIV clin…
Inclusion Criteria: * Have been diagnosed with HIV; * Receive care at one of the participating sites; * Are \>18 years old; * Have smoked \>100 cigarettes lifetime; * Smoke everyday or some days; * Smoke, on average, \>5 cigarettes per day; and * Provide written informed consent. Exclusion Criteria: * Exclusive use of non-cigarette tobacco or nicotine products, including e-cigarettes; * Self-report or urine testing confirming pregnancy, nursing, or trying to conceive; * Life-threatening or unstable medical, surgical, or psychiatric condition; * Anticipate being unable to return for follow-u…
Clinical pharmacist prescribed MTUD, based on participant choice: nicotine patch, nicotine gum, nicotine lozenge, varenicline, bupropion. Participants on nicotine replacement may choose both a long acting (patch) and short acting (gum, lozenge) option to use at the same time.
Participants will earn prizes for progress towards tobacco abstinence, achieving tobacco abstinence, and progress in improving HIV and other related health conditions.
Participants will receive a booster call by a teamlet member after MTUD is prescribed to address any MTUD access issues and answer MTUD related questions.