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Tobacco Use in the MMC ID Clinic Population: Clinical and Research Activities

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.

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Tobacco Use in the MMC ID Clinic Population: Clinical and Research Activities

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  1. Tobacco Use in the MMC ID Clinic Population: Clinical and Research Activities AECOM/MMC Tobacco Think Tank September 8, 2009

  2. 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.

  3. 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

  4. 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)

  5. 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

  6. 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)

  7. 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

  8. 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

  9. 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

  10. Tobacco Use and Antiretroviral Adherence

  11. 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

  12. Pending Application • R01 (Shuter, Stanton, Moadel, Strecher, Niaura): RCT of a tailored web-based smoking cessation vs. standard care for PLWHA smokers

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