A pilot study of a smoking cessation intervention for women living with HIV: study protocol

Figures & data

Figure 1 Flowchart of the study.

Table 1 Scripted interview guide for screening

No.	Screening question	Correct answer
1	Can you speak English?	Yes
2	Have you been diagnosed with HIV infection?	Yes
	Do you know your CD4 cell count and viral load? (This question is asked as a way to verify HIV infection.) What are they?	Yes
3	What kind of medications are you currently taking for HIV infection? (This question is asked as a way to verify HIV infection.)	Any HIV medications
4	How old are you?	18–75
5	How many cigarettes on average have you been smoking a day?	≥5 cigarettes
6	How long have you been smoking daily?	≥6 months
7	Are you willing to quit smoking within the next 4 weeks?	Yes
8	Do you have any active skin disease?	No
9	Have you had emotional complications such as feeling anxious and depressed around quitting smoking?	No
10	Do you currently receive treatments (counseling and pharmacotherapy) for any of these conditions: alcohol use disorder, schizophrenia, schizoaffective disorder, and bipolar disorder?	No
11	Have you ever attempted to kill yourself within the past 10 years?	No
12	Do you currently use any illegal substances except marijuana (weed)?	No
13	Are you pregnant or lactating?	No
14	Will you agree to use birth control pills or devices during the study period if you are between the ages of 18 and 50 and sexually active?	Yes
15	Do you have access to a smartphone or computer with an Internet connection?	Yes

Abbreviation: HIV, human immunodeficiency virus.

Table 2 Intervention components of each session

Session number	Agenda	Intervention components
1	Assessment and planning	Assess the importance of quitting and confidence in quitting
		Select the target quit day
		Discuss how to change one’s smoking pattern toward quitting
		Assign the homework of an hourly smoking log
		Educate what smoking does to people with HIV
		Instill hope for smoking cessation
2	Health benefits of quitting	Discuss the immediate health benefits of quitting
		Inform high morbidity and mortality of AIDS-related cancers among women who smoke compared to those who do not smoke
		Encourage the participant to watch CDC’s video clips of former smokers: smoking and HIV
		Explain the neurobiologic changes in the brain associated with nicotine addiction
3	Quit day preparation	Explain the underlying mechanism, effects, and side effects of nicotine patches and how to manage the side effects
		Counsel behavior changes in preparation for the quit day
		Explain the possible drug-to-drug interactions between nicotine patches and HIV medications
4	First post-quit assessment	Assess nicotine withdrawal symptoms, lapse/relapse, adherence to nicotine patches, and any side effects of nicotine patches
		Educate proper management of patch problems
		Counsel behavioral coping strategies for nicotine withdrawal symptoms
5	Lapses and relapses	Assess nicotine withdrawal symptoms and lapse/relapse
		Discuss helpful cessation strategies including 4Ds (delay, deep breathing, drink water, and distract)
		Counsel how to manage smoking tempting situations
6	Stress and coping skills	Assess nicotine withdrawal symptoms and lapse/relapse
		Counsel to understand the effects of negative cognitions and moods (e.g., depression and anxiety) on relapse
		Discuss positive coping skills
		Encourage exercise and healthy living lifestyle change
7	Medication adherence	Assess medication adherence
		Discuss any positive changes experienced in the body
		Explain the importance of adherence to nicotine patches
		Remind the dosage decrease in nicotine patches (from step 1, 21 mg to step 2, 14 mg)
8	Relapse prevention	Discuss the strategies to avoid lapses/relapses at high-risk situations (e.g., meeting a friend with whom the participant used to smoke)
		Revisit the importance of medication adherence
		Encourage to reframe self as an ex-smoker
		Encourage to participate in various group activities (e.g., nicotine anonymous telephone group and gym exercise group)

Abbreviations: AIDS, acquired immune deficiency syndrome; CDC, Centers for Disease Control and Prevention; HIV, human immunodeficiency virus.