Receipt and predictors of smoking cessation pharmacotherapy among veterans with and without HIV.

Shahrir S, Crothers K, McGinnis KA, Chan KCG, Baeten JM, Wilson SM, Butt AA, Pisani MA, Baldassarri SR, Justice A, Williams EC. Receipt and predictors of smoking cessation pharmacotherapy among veterans with and without HIV. Progress in Cardiovascular Diseases. 2020 Mar 1; 63(2):118-124.

Related HSR&D Project(s)

• CDA 12-276 – Implementation Research for Evidence-based Care for Alcohol Dependence
• CDA 17-005 – A Personalized mHealth Approach to Smoking Cessation for Veterans Living with HIV

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Abstract:

Smoking is highly prevalent among people living with HIV (PLWH) and increases cardiovascular risk. Pharmacotherapies such as nicotine replacement therapy (NRT), bupropion, and varenicline help to reduce smoking, though rates of receipt among PLWH compared with HIV-uninfected persons are unknown. Among 814 PLWH and 908 uninfected patients enrolled in the Veterans Aging Cohort Study (2012-2017) who reported current smoking, we used marginal multivariable log-linear regression models to estimate adjusted relative risks (ARR) of receiving pharmacotherapy by HIV status. We also assessed patient-level factors associated with pharmacotherapy receipt within each group. In multivariable analyses, receipt of NRT was less likely among PLWH relative to uninfected participants (ARR 0.77, 95% CI 0.67, 0.89). In both populations, documented mental health disorders and contemplation to quit were associated with greater likelihood of receiving pharmacotherapy. Further research is needed to explore potential treatment disparities.