[Smoking cessation among HIV smokers: Experience of a French hospital-based smoking cessation service].

INTRODUCTION

There is a particular need among HIV-infected patients to stop smoking because of the risk of smoking-related complications and the high prevalence of cigarette smoking among them. Only a few studies have focused on this population in real-world settings.

AIM OF THE STUDY

Investigate the effectiveness of a smoking cessation support for HIV-infected patients at the Georges Pompidou University hospital (HEGP) smoking cessation service during the 2011-2012 period.

METHODS

A retrospective study of smoking cessation medical records was performed for 39 smokers who had visited for the first time the HEGP smoking cessation service during the 2011-2012 period and declared to be infected by the HIV on their smoking cessation self-questionnaire. The study has described smokers' characteristics and follow-up to measure the abstinence rate, validated by the patient declaration, the registration of the number of days without cigarettes between each visit and a measure of expired carbon monoxide ≤ 5ppm at each visit. We examined smokers lost to follow-up and they have been considered as smokers. Maintained abstinence rates at 3 month-follow-up and at 9 months/one year were registered.

RESULTS

The 39 HIV-infected smokers registered in the study were mainly male (30/39), were heavy smokers with a consumption mean of nearly 23 cigarettes per day. One third presented high nicotine dependence with a Fagerström test ≥ 7. A depression history was reported among one third of them. Symptoms of anxiety and depression were declared by 20% and 33% respectively among them. Thirteen percent of them received opioid replacement therapies, 41% were cannabis users (one out of four were daily users) and 10 % declared alcohol abuse. 85% of patients received nicotine replacement therapy (patch and/or oral forms) and 15% varenicline, along with behavioral support techniques. At 3 month-follow-up, smoking cessation was validated for 20.5% of patients and at 9 months/1 year, smoking cessation rate decreased at 13%. When considering smokers with ≥ 2 visits, the maintained abstinence rates were respectively 27.6 and 17.2%.

DISCUSSION AND CONCLUSION

With a severe smoking profile, frequent co-addictions and anxiodepressive symptoms, our results suggest that behavioral techniques combined with nicotine replacement therapy or varenicline among HIV-infected smokers can help severe smokers to quit. Our data underline the need to take into account the co-addictions and to maintain such patients in treatment to achieve smoking cessation in real-world settings.