Outcome of smoking cessation counselling of <scp>HIV</scp>‐positive persons by <scp>HIV</scp> care physicians

HIV Medicine - Tập 13 Số 7 - Trang 387-397 - 2012
Michael Huber1, Bruno Ledergerber1, Rafael Sauter2, Jim Young3, Jan Fehr1, Alexia Cusini4, Manuel Battegay5, Alexandra Calmy6, Christina Orasch7, Dunja Nicca8, Enos Bernasconi9, R Jaccard10, Leonhard Held2, Rainer Weber1
1Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
2Division of Biostatistics, Institute for Social and Preventive Medicine, University of Zurich, Zurich, Switzerland
3Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
4Division of Infectious Diseases Berne University Hospital and University of Berne Berne Switzerland
5Division of Infectious Diseases, University Hospital Basel, Basel, Switzerland
6Division of Infectious Diseases, University Hospital Geneva, Geneva, Switzerland
7Division of Infectious Diseases Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne Switzerland
8Division of Infectious Diseases, Cantonal Hospital of St Gallen, St Gallen, Switzerland
9Division of Infectious Diseases Regional Hospital Lugano Switzerland
10‘HIV‐Pract’ (Private Practices) Zurich Switzerland

Tóm tắt

ObjectivesSmoking 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.MethodsThe Swiss HIV Cohort Study (SHCS) is a multicentre prospective observational database. Our single‐centre intervention at the Zurich 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 Zurich 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.ResultsBetween April 2000 and December 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 Zurich centre from November 2007 to December 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.ConclusionsAn institution‐wide training programme for HIV care physicians in smoking cessation counselling led to increased smoking cessation and fewer relapses.

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HIV Medicine

Tập 13 Số 7

387-397

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