Tobacco Use in the MMC ID Clinic Population: Clinical and Research Activities AECOM/MMC Tobacco...
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Transcript of Tobacco Use in the MMC ID Clinic Population: Clinical and Research Activities AECOM/MMC Tobacco...
Tobacco Use in the MMC ID Clinic Population: Clinical and
Research Activities
AECOM/MMC Tobacco Think Tank
September 8, 2009
Cigarette smoking is epidemic among PLWHAs in the USA. 60% of the MMC ID Clinic patients are active cigarette smokers.
State and national statistics are describing significant increases in incidences of cardiac events, COPD/emphysema, lung, and oropharyngeal cancer in this population.
American Legacy Foundation 2006-7
• Shuter, Moadel, Bernstein• Study of the biobehavioral bases of smoking and
quitting in a random sample of PLWHA smokers and ex-smokers
• 60 smokers and 30 ex-smokers completed in-depth, one-on-one structured interviews
• A smoking cessation brochure was developed in response to the information gathered
American Legacy Foundation 2007-2008
• Shuter, Moadel, Bernstein• Used data collected in Year 1 to develop the
Positively Smoke Free intensive cessation program curriculum, and piloted it in six groups of PLWHA smokers
• Matching funds: Latino Commission on AIDS (NYSDOH), Bronx BREATHES (Bernstein)
American Legacy Foundation 2008-2009
• Shuter, Strecher (U. Michigan)• Developed Positively Smoke Free on the
Web, the first and only web-based cessation program that targets smokers living with HIV/AIDS
• www.positivelysmokefree.com
American Legacy Foundation 2009-2010
• Shuter, Strecher (U. Michigan)• Develop a Spanish version of Positively
Smoke Free on the Web• Incorporate a library of provider resources
on the website• Matching funds AECOM Cancer Prevention
and Control Research Program (Rapkin)
RCT of Positively Smoke Free on-site Intensive Intervention
• R21 NIDA (Shuter, Moadel, Bernstein, Arnsten)
• Will create a revised version of the curriculum that incorporates buddy support into the treatment model
• RCT of intensive intervention vs. standard of care (85 per study condition)
• Primary outcome=3 month abstinence
Motivating Latinos to Quit Smoking
• R01 NIDA (Niaura/Stanton PIs [Brown University], Shuter, Moadel co-Inv.)
• RCT of one-on-one culturally tailored counseling sessions versus standard of care
• Projected MMC enrollment=100• Primary endpoint=12 month abstinence
Translational Research
• Exhaled DNA methylation in HIV-infected vs. uninfected individuals
• CFAR-AECC pilot grant (Spivack, Shuter)• Plan to enroll 100 PLWHA subjects
(smokers, ex-smokers, never smokers)• 17 enrolled to date
Provider Attitudes and Beliefs about Tobacco Use
• Unfunded study: Shuter, Moadel• Survey of the HIVMA on-line provider
registry• 363 completed surveys (75%) from
providers caring for 75,000 PLWHAs in 46 states
• Analysis is ongoing
Pending Application
• R01 (Shuter, Stanton, Moadel, Strecher, Niaura): RCT of a tailored web-based smoking cessation vs. standard care for PLWHA smokers