Background
Persons with HIV (PWH) in the United States (US) smoke cigarettes at approximately triple the rate of the general adult population and are less successful in their quit attempts than other smokers. This randomized trial tested whether a novel web-based cessation program for PWH yielded higher cigarette quit rates compared to a control program.
Setting
Two urban HIV care sites in NYC and Baltimore
Methods
Between 2016 and 2020, 506 PWH were randomized to either Positively Smoke Free on the Web (PSFW+; N=255), a multimodal platform, interactive web intervention hosted within an online social network to support quitting among PWH who smoke, and an attention-matched web-based control intervention (American Heart Association Getting Healthy; AHA; N=251). All participants were offered 12 weeks of nicotine patch. Our primary outcome was biochemically-confirmed exhaled carbon monoxide (ECO)<10 parts per million (ppm) seven-day point prevalence abstinence at 6-months.
Results
Participants were middle-aged (mean 50.2 yrs; range 23–73), 57% male, and 19% Latinx, 83% Black, 13% White. At 6-months, a significantly greater percentage of PSFW+ participants (14.9%) achieved biochemically confirmed seven-day point prevalence abstinence in intent-to-treat analysis compared to 8.8% of AHA participants (O.R. =1.82 [95% C.I. =1.04–3.18], P=.03).
Conclusions
PSFW+ is a promising cessation intervention composed of empirically-tested content and real-time social support through an online social network that was found to promote abstinence. This digital approach has broad reach and scalability, can be easily integrated into comprehensive HIV care, and represents an advance in the fight against tobacco use among PWH.
