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Outcome of smoking cessation counselling of HIV ‐positive persons by HIV care physicians
Author(s) -
Huber M,
Ledergerber B,
Sauter R,
Young J,
Fehr J,
Cusini A,
Battegay M,
Calmy A,
Orasch C,
Nicca D,
Bernasconi E,
Jaccard R,
Held L,
Weber R
Publication year - 2012
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2011.00984.x
Subject(s) - medicine , smoking cessation , odds ratio , confidence interval , checklist , logistic regression , family medicine , human immunodeficiency virus (hiv) , cohort , intervention (counseling) , physical therapy , psychiatry , psychology , pathology , cognitive psychology
Objectives Smoking is the most prevalent modifiable risk factor for cardiovascular diseases among HIV ‐positive persons. We assessed the effect on smoking cessation of training HIV care physicians in counselling. Methods The S wiss HIV C ohort S tudy ( SHCS ) is a multicentre prospective observational database. Our single‐centre intervention at the Z urich centre included a half day of standardized training for physicians in counselling and in the pharmacotherapy of smokers, and a physicians' checklist for semi‐annual documentation of their counselling. Smoking status was then compared between participants at the Z urich centre and other institutions. We used marginal logistic regression models with exchangeable correlation structure and robust standard errors to estimate the odds of smoking cessation and relapse. Results Between A pril 2000 and D ecember 2010, 11 056 SHCS participants had 121 238 semi‐annual visits and 64 118 person‐years of follow‐up. The prevalence of smoking decreased from 60 to 43%. During the intervention at the Z urich centre from N ovember 2007 to D ecember 2009, 1689 participants in this centre had 6068 cohort visits. These participants were more likely to stop smoking [odds ratio ( OR ) 1.23; 95% confidence interval ( CI ) 1.07–1.42; P = 0.004] and had fewer relapses ( OR 0.75; 95% CI 0.61–0.92; P = 0.007) than participants at other SHCS institutions. The effect of the intervention was stronger than the calendar time effect ( OR 1.19 vs. 1.04 per year, respectively). Middle‐aged participants, injecting drug users, and participants with psychiatric problems or with higher alcohol consumption were less likely to stop smoking, whereas persons with a prior cardiovascular event were more likely to stop smoking. Conclusions An institution‐wide training programme for HIV care physicians in smoking cessation counselling led to increased smoking cessation and fewer relapses.