Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite, Philadelphia, PA, 4100, USA.
Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Psychopharmacology (Berl). 2021 Feb;238(2):529-537. doi: 10.1007/s00213-020-05701-x. Epub 2020 Nov 12.
People with HIV (PWH) smoke cigarettes at much higher rates than the general population and evidence-based cessation methods are less effective, putting PWH at greater risk for negative health outcomes. It is critical to identify the factors that underlie this health disparity. Delay discounting-the decline in the value of a reward when it is delayed-may explain this disparity.
This study aimed to (1) compare delay discounting between adult smokers with HIV and without HIV and (2) evaluate whether acute smoking abstinence disproportionately increases delay discounting among smokers with HIV.
This sub-study was part of a larger study (NCT03169101) examining predictors of smoking cessation outcomes among smokers with HIV (n = 34) and smokers without HIV (n = 46) at two counterbalanced laboratory sessions (once smoking-as-usual and once following 24-h biochemically confirmed abstinence) then again, after 8 weeks of smoking cessation treatment.
There were no significant differences in delay discounting rates between HIV status groups (p = 0.49) or within-subject abstinence effects (p = 0.70). However, smokers without HIV exhibited a significant increase in delay discounting following smoking cessation treatment compared to baseline (p = 0.02), whereas the change among smokers with HIV did not reach statistical significance (p = 0.09).
These findings do not support differences in delay discounting as a reason for the lower success rates of HIV+ smokers at quitting. Although delay discounting may not explain the disparity in smoking rates between people with and without HIV, future work should focus on additional correlates of higher smoking rates and lower quit rates among people with HIV.
HIV 感染者（PWH）吸烟率远高于普通人群，基于证据的戒烟方法效果较差，使 PWH 面临更大的健康风险。因此，确定导致这一健康差异的因素至关重要。延迟折扣——当奖励延迟时奖励价值的下降——可能解释了这一差异。
本研究旨在（1）比较 HIV 阳性和 HIV 阴性成年吸烟者的延迟折扣率，（2）评估急性戒烟是否会不成比例地增加 HIV 感染者的延迟折扣率。
本子研究是一项更大规模研究（NCT03169101）的一部分，该研究旨在检验 HIV 感染者（n=34）和 HIV 阴性吸烟者（n=46）在两个平衡的实验室环境下（一次为吸烟常态，一次为 24 小时生物化学确认的戒烟后）的戒烟结果预测因素，然后在 8 周的戒烟治疗后再次评估。
HIV 状态组之间（p=0.49）或个体内戒烟效果（p=0.70）的延迟折扣率没有显著差异。然而，与基线相比，无 HIV 感染者在戒烟治疗后延迟折扣率显著增加（p=0.02），而 HIV 感染者的变化没有达到统计学意义（p=0.09）。
这些发现不支持将延迟折扣作为 HIV+吸烟者戒烟成功率较低的原因。虽然延迟折扣可能无法解释 HIV 阳性者和阴性者之间吸烟率差异的原因，但未来的研究应重点关注 HIV 感染者吸烟率较高和戒烟率较低的其他相关因素。
