Levy Sera, Schnoll Robert A, Wileyto E Paul, Thompson Morgan, Azad Manaal, Metzger David, Leone Frank, Ashare Rebecca L
Department of Psychology, State University of New York at Buffalo, Buffalo, NY, USA.
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Nicotine Tob Res. 2025 Jun 27. doi: 10.1093/ntr/ntaf115.
High rates of smoking among people with HIV (PWH) persist and may be due to HIV-associated neurocognitive disorders exacerbating abstinence-induced cognitive deficits, leading to higher risk of relapse. This study assessed differences in smoking abstinence rates and abstinence-induced cognitive deficits among PWH and people without (PWOH).
In this prospective observational design (NCT03169101), treatment-seeking adults completed two laboratory sessions during a pre-quit phase to assess cognition: once following 24h abstinence and once smoking-as-usual. Cognition was measured through response inhibition, working memory, and verbal memory tasks. All received standard smoking cessation treatment over 8 weeks (i.e., counseling, nicotine patch). Point-prevalence abstinence was assessed at end-of-treatment.
Our sample included 210 participants (38.1% PWH; 61.9% PWOH), who were mostly male (59.5%) and Black/African-American (76.7%). No significant HIV status by abstinence condition interactions emerged for any cognitive outcome (all ps > .4). There were significant abstinence-induced deficits in response inhibition (p = .02), working memory response time (p = .005), and verbal memory (p=<.001). No significant differences emerged in abstinence rates between PWH and PWOH (31.2%, 32.3%, respectively; OR = 1.26, 95% CI: 0.67, 2.39, p = .48).
Despite prior research suggesting differences in abstinence rates and cognition between PWH and PWOH who smoke, hypotheses were not supported. However, this is one of a few studies to directly compare people with and without HIV in a rigorously designed mechanistic smoking cessation study. Given that cognition does not appear to play a primary role in smoking among PWH, more work is needed to understand the mechanisms driving disproportionate smoking rates among PWH.
艾滋病毒感染者（PWH）中的高吸烟率持续存在，这可能是由于与艾滋病毒相关的神经认知障碍加剧了戒烟引起的认知缺陷，导致更高的复发风险。本研究评估了PWH与未感染艾滋病毒者（PWOH）在戒烟率和戒烟引起的认知缺陷方面的差异。
在这项前瞻性观察性设计（NCT03169101）中，寻求治疗的成年人在戒烟前阶段完成了两次实验室测试以评估认知：一次是在24小时戒烟后，一次是在照常吸烟时。通过反应抑制、工作记忆和言语记忆任务来测量认知。所有人都接受了为期8周的标准戒烟治疗（即咨询、尼古丁贴片）。在治疗结束时评估点患病率戒烟情况。
我们的样本包括210名参与者（38.1%为PWH；61.9%为PWOH），他们大多为男性（59.5%），黑人/非裔美国人（76.7%）。对于任何认知结果，均未出现按戒烟状况与艾滋病毒感染状况的显著交互作用（所有p值>0.4）。在反应抑制（p = 0.02）、工作记忆反应时间（p = 0.005）和言语记忆（p<0.001）方面，存在显著的戒烟引起的缺陷。PWH和PWOH之间的戒烟率没有显著差异（分别为31.2%和32.3%；OR = 1.26，95%CI：0.67，2.39，p = 0.48）。
尽管先前的研究表明吸烟的PWH和PWOH在戒烟率和认知方面存在差异，但这些假设未得到支持。然而，这是少数几项在严格设计的机制性戒烟研究中直接比较感染和未感染艾滋病毒者的研究之一。鉴于认知似乎在PWH吸烟中不发挥主要作用，则需要开展更多工作来了解导致PWH中吸烟率不成比例的机制。
