Journal of Cancer Education

, Volume 34, Issue 6, pp 1045–1058 | Cite as

A Qualitative Systematic Review of Cigarette Smoking Cessation Interventions for Persons Living with HIV

  • Lilli Mann-JacksonEmail author
  • David Choi
  • Erin L. Sutfin
  • Eunyoung Y. Song
  • Kristie L. Foley
  • Aimee M. Wilkin
  • Caryn G. Morse
  • Nicole F. Rojas
  • Timothy S. Oh
  • Scott D. Rhodes


Persons living with HIV (PLWH) have disproportionately high rates of both cigarette smoking and tobacco-induced negative health outcomes. The goal of this qualitative systematic review was to identify gaps in the existing literature and future directions for smoking cessation support for PLWH. Three online databases were searched from their inception through December 31, 2017, using designated search terms. Peer-reviewed English-language articles that documented an intervention designed to increase smoking cessation among PLWH were reviewed. Data were abstracted using a standardized form to document study and intervention characteristics and results. Thirty-two articles, describing 28 unique intervention studies, met inclusion criteria. Interventions consisted primarily of combinations of counseling, pharmacotherapy, and the use of information and communications technology; few interventions were implemented at the clinic level. Thirteen interventions resulted in significant improvements in cessation-related outcomes. Information and communications technology and clinic-level interventions had the greatest potential for increasing smoking cessation among PLWH. Efficacious interventions designed for PLWH in the US South, and for groups of PLWH facing additional health disparities (e.g., communities of color and sexual and gender minorities), are needed. There is also a need for more rigorous research designs to test the efficacy of interventions designed to increase cessation-related outcomes among PLWH.


Smoking Cessation Persons living with HIV Intervention Systematic review 


Funding information

This review was supported by the National Center for Advancing Translational Sciences (UL1TR001420).


  1. 1.
    Centers for Disease Control and Prevention (2018) Smoking is down, but almost 38 million American adults still smoke. Accessed 4 Nov 2018
  2. 2.
    Centers for Disease Control and Prevention (2018) Burden of tobacco use in the U.S. Accessed 4 Nov 2018
  3. 3.
    U.S. Department of Health & Human Services (2017) Smoking and HIV. Accessed 4 Nov 2018
  4. 4.
    Mdodo R, Frazier EL, Dube SR, Mattson CL, Sutton MY, Brooks JT, Skarbinski J (2015) Cigarette smoking prevalence among adults with HIV compared with the general adult population in the United States: cross-sectional surveys. Ann Intern Med 162:335–344. CrossRefPubMedGoogle Scholar
  5. 5.
    Reynolds NR (2009) Cigarette smoking and HIV: more evidence for action. AIDS Educ Prev 21:106–121. CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Miguez-Burbano MJ, Ashkin D, Rodriguez A, Duncan R, Pitchenik A, Quintero N, Flores M, Shor-Posner G (2005) Increased risk of Pneumocystis carinii and community-acquired pneumonia with tobacco use in HIV disease. Int J Infect Dis 9:208–217. CrossRefPubMedGoogle Scholar
  7. 7.
    Bénard A, Mercié P, Alioum A et al (2010) Bacterial pneumonia among HIV-infected patients: decreased risk after tobacco smoking cessation. ANRS CO3 Aquitaine cohort, 2000-2007. PLoS One 5:e8896. CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Morris A, George MP, Crothers K, Huang L, Lucht L, Kessinger C, Kleerup EC, on behalf of the Lung HIV Study (2011) HIV and chronic obstructive pulmonary disease: is it worse and why? Proc Am Thorac Soc 8:320–325. CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Althoffm Keri N, Gange SJ, Achenbach C et al (2015) Smoking outweighs HIV-related risk factors for non–AIDS-defining cancers. Presented at Conference on Retroviruses and Opportunistic Infections, Seattle, WashingtonGoogle Scholar
  10. 10.
    Zhao L, Li F, Zhang Y, Elbourkadi N, Wang Z, Yu C, Taylor EW (2010) Mechanisms and genes involved in enhancement of HIV infectivity by tobacco smoke. Toxicology 278:242–248. CrossRefPubMedGoogle Scholar
  11. 11.
    Helleberg M, May MT, Sterne JAC, Obel N (2014) Impact of smoking on life expectancy among HIV-infected individuals: the ART cohort collaboration. Presented at conference on retroviruses and opportunistic infections, Boston, MAGoogle Scholar
  12. 12.
    Reddy KP, Kong CY, Hyle EP, Baggett TP, Huang M, Parker RA, Paltiel AD, Losina E, Weinstein MC, Freedberg KA, Walensky RP (2017) Lung cancer mortality associated with smoking and smoking cessation among people living with HIV in the United States. JAMA Intern Med 177:1613–1621. CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Helleberg M, Gerstoft J, Afzal JS et al (2014) Impact of smoking on risk of cancer among HIV patients compared to the background population. Presented at Conference on Retroviruses and Opportunistic Infections, Boston, MAGoogle Scholar
  14. 14.
    Nahvi S, Cooperman NA (2009) Review: the need for smoking cessation among HIV-positive smokers. AIDS Educ Prev 21:14–27. CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Lifson AR, Lando HA (2012) Smoking and HIV: prevalence, health risks, and cessation strategies. Curr HIV/AIDS Rep 9:223–230. CrossRefPubMedGoogle Scholar
  16. 16.
    Chander G, Stanton C, Hutton HE, Abrams DB, Pearson J, Knowlton A, Latkin C, Holtgrave D, Moore RD, Niaura R (2012) Are smokers with HIV using information and communication technology? Implications for behavioral interventions. AIDS Behav 16:383–388. CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Fiore MC, Roberto Jaén C, Baker TB et al (2008) Treating tobacco use and dependence: 2008 update. U.S. Department of Health and Human Services, Washington, DCGoogle Scholar
  18. 18.
    Stead LF, Buitrago D, Preciado N, Sanchez G, Hartmann-Boyce J, Lancaster T, Cochrane Tobacco Addiction Group (2013) Physician advice for smoking cessation. Cochrane Database Syst Rev:CD000165.
  19. 19.
    Crothers K, Goulet JL, Rodriguez-Barradas MC, Gibert CL, Butt AA, Braithwaite RS, Peck R, Justice AC (2007) Decreased awareness of current smoking among health care providers of HIV-positive compared to HIV-negative veterans. J Gen Intern Med 22:749–754. CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Reif S, Pence BW, Hall I, Hu X, Whetten K, Wilson E (2015) HIV diagnoses, prevalence and outcomes in nine southern states. J Community Health 40:642–651. CrossRefPubMedGoogle Scholar
  21. 21.
    Jamal A, Homa DM, O’Connor E, Babb SD, Caraballo RS, Singh T, Hu SS, King BA (2015) Current cigarette smoking among adults - United States, 2005-2014. MMWR Morb Mortal Wkly Rep 64:1233–1240. CrossRefPubMedGoogle Scholar
  22. 22.
    Centers for Disease Control and Prevention (2018) Hispanics/Latinos and tobacco use. Accessed 21 Nov 2018
  23. 23.
    Centers for Disease Control and Prevention (2018) African Americans and tobacco use. Accessed 21 Nov 2018
  24. 24.
    Centers for Disease Control and Prevention (2018) HIV in the United States: At a glance. Accessed 21 Nov 2018
  25. 25.
    Phillips JC, Oliffe JL, Ensom MHH, Bottorff JL, Bissell LJL, Boomer J, O’Brien KMK, Howard T, Khara M (2012) An overlooked majority: HIV-positive gay men who smoke. J Men's Health 9:17–24. CrossRefGoogle Scholar
  26. 26.
    Akhtar-Khaleel WZ, Cook RL, Shoptaw S, Surkan P, Stall R, Beyth RJ, Teplin LA, Plankey M (2016) Trends and predictors of cigarette smoking among HIV seropositive and seronegative men: the multicenter AIDS cohort study. AIDS Behav 20:622–632. CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Centers for Disease Control and Prevention (2018) Lesbian, gay, bisexual, and transgender persons and tobacco use. Accessed 21 Nov 2018
  28. 28.
    Centers for Disease Control and Prevention (2018) HIV among transgender people. Accessed 21 Nov 2018
  29. 29.
    Meade MO, Richardson WS (1998) Selecting and appraising studies for systematic review. In: Mulrow CD, Cook D (eds) Systematic reviews: synthesis of best evidence for health care decisions. ACP Press, Philadelphia, pp 81–90Google Scholar
  30. 30.
    Balfour L, Wiebe SA, Cameron WD, Sandre D, Pipe A, Cooper C, Angel J, Garber G, Holly C, Dalgleish TL, Tasca GA, MacPherson PA (2017) An HIV-tailored quit-smoking counselling pilot intervention targeting depressive symptoms plus nicotine replacement therapy. AIDS Care 29:24–31. CrossRefPubMedGoogle Scholar
  31. 31.
    Lloyd-Richardson EE, Stanton CA, Papandonatos GD, Shadel WG, Stein M, Tashima K, Flanigan T, Morrow K, Neighbors C, Niaura R (2009) Motivation and patch treatment for HIV+ smokers: a randomized controlled trial. Addiction 104:1891–1900. CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Browning KK, Wewers ME, Ferketich AK, Diaz P, Koletar SL, Reynolds NR (2016) Adherence to tobacco dependence treatment among HIV-infected smokers. AIDS Behav 20:608–621. CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Chew D, Steinberg MB, Thomas P et al (2014) Evaluation of a smoking cessation program for HIV infected individuals in an urban HIV clinic: challenges and lessons learned. AIDS Res Treat 2014:237834. CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Cropsey KL, Hendricks PS, Jardin B, Clark CB, Katiyar N, Willig J, Mugavero M, Raper JL, Saag M, Carpenter MJ (2013) A pilot study of screening, brief intervention, and referral for treatment (SBIRT) in non-treatment seeking smokers with HIV. Addict Behav 38:2541–2546. CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Cropsey KL, Jardin BF, Burkholder GA, Clark CB, Raper JL, Saag MS (2015) An algorithm approach to determining smoking cessation treatment for persons living with HIV/AIDS: results of a pilot trial. J Acquir Immune Defic Syndr 69:291–298. CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Valera P, McClernon FJ, Burkholder F et al (2017) A pilot trial examining African American and White responses to algorithm-guided smoking cessation medication selection in persons living with HIV. AIDS Behav 21:1975–1984. CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Cui Q, Robinson L, Elston D, Smaill F, Cohen J, Quan C, McFarland N, Thabane L, McIvor A, Zeidler J, Smieja M (2012) Safety and tolerability of varenicline tartrate (Champix(®)/Chantix(®)) for smoking cessation in HIV-infected subjects: a pilot open-label study. AIDS Patient Care STDs 26:12–19. CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Cummins D, Trotter G, Moussa M, Turham G (2005) Smoking cessation for clients who are HIV-positive. Nurs Stand 20:41–47. CrossRefPubMedGoogle Scholar
  39. 39.
    Elzi L, Spoerl D, Voggensperger J et al (2006) A smoking cessation programme in HIV-infected individuals: a pilot study. Antivir Ther 11:787–795PubMedGoogle Scholar
  40. 40.
    Ferketich AK, Diaz P, Browning KK, Lu B, Koletar SL, Reynolds NR, Wewers ME (2013) Safety of varenicline among smokers enrolled in the lung HIV study. Nicotine Tob Res 15:247–254. CrossRefPubMedGoogle Scholar
  41. 41.
    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, Swiss HIV Cohort Study Group (2012) Outcome of smoking cessation counselling of HIV-positive persons by HIV care physicians. HIV Medicine 13:387–397. CrossRefPubMedGoogle Scholar
  42. 42.
    Humfleet GL, Hall SM, Delucchi KL, Dilley JW (2013) A randomized clinical trial of smoking cessation treatments provided in HIV clinical care settings. Nicotine Tob Res 15:1436–1445. CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Ingersoll KS, Cropsey KL, Heckman CJ (2009) A test of motivational plus nicotine replacement interventions for HIV positive smokers. AIDS Behav 13:545–554. CrossRefPubMedGoogle Scholar
  44. 44.
    Krebs P, Tseng T-Y, Pham H, Wong S, Sherman SE, Shelley D, Furberg RD, Wolfe H (2015) Formative evaluation of a text messaging intervention to promote varenicline adherence among tobacco-dependent persons with HIV. J Health Commun 20:1021–1025. CrossRefPubMedGoogle Scholar
  45. 45.
    Tuo-Yen T, Krebs P, Schoenthaler A et al (2017) Combining text messaging and telephone counseling to increase varenicline adherence and smoking abstinence among cigarette smokers living with HIV: a randomized controlled study. AIDS Behav 21:1964–1974. CrossRefGoogle Scholar
  46. 46.
    Lazev A, Vidrine D, Arduino R, Gritz E (2004) Increasing access to smoking cessation treatment in a low-income, HIV-positive population: the feasibility of using cellular telephones. Nicotine Tob Res 6:281–286. CrossRefPubMedGoogle Scholar
  47. 47.
    de Dios MA, Stanton CA, Cano MÁ et al (2016) The influence of social support on smoking cessation treatment adherence among HIV+ smokers. Nicotine Tob Res 18:1126–1133. CrossRefPubMedGoogle Scholar
  48. 48.
    Manuel JK, Lum PJ, Hengl NS, Sorensen JL (2013) Smoking cessation interventions with female smokers living with HIV/AIDS: a randomized pilot study of motivational interviewing. AIDS Care 25:820–827. CrossRefPubMedGoogle Scholar
  49. 49.
    Matthews AK, Conrad M, Kuhns L, Vargas M, King AC (2013) Project exhale: preliminary evaluation of a tailored smoking cessation treatment for HIV-positive African American smokers. AIDS Patient Care STDs 27:22–32. CrossRefPubMedGoogle Scholar
  50. 50.
    King A, Sánchez-Johnsen L, Van Orman S et al (2008) A pilot community-based intensive smoking cessation intervention in African Americans: feasibility, acceptability and early outcome indicators. J Natl Med Assoc 100:208–217CrossRefGoogle Scholar
  51. 51.
    Moadel AB, Bernstein SL, Mermelstein RJ, Arnsten JH, Dolce EH, Shuter J (2012) A randomized controlled trial of a tailored group smoking cessation intervention for HIV-infected smokers. J Acquir Immune Defic Syndr 61:208–215. CrossRefPubMedPubMedCentralGoogle Scholar
  52. 52.
    Mussulman LM, Faseru B, Fitzgerald S, Nazir N, Patel V, Richter KP (2018) A randomized, controlled pilot study of warm handoff versus fax referral for hospital-initiated smoking cessation among people living with HIV/AIDS. Addict Behav 78:205–208. CrossRefPubMedGoogle Scholar
  53. 53.
    Nerín I, Novella P, Beamonte A et al (2007) Results of smoking cessation therapy in a specialist unit. Archivos De Bronconeumologia 43:669–673PubMedGoogle Scholar
  54. 54.
    Shadel WG, Galvan FH, Tucker JS (2016) Developing a nicotine patch adherence intervention for HIV-positive Latino smokers. Addict Behav 59:52–57. CrossRefPubMedPubMedCentralGoogle Scholar
  55. 55.
    Shuter J, Morales DA, Considine-Dunn SE, An LC, Stanton CA (2014) Feasibility and preliminary efficacy of a web-based smoking cessation intervention for HIV-infected smokers: a randomized controlled trial. J Acquir Immune Defic Syndr 67:59–66. CrossRefPubMedPubMedCentralGoogle Scholar
  56. 56.
    Stanton CA, Papandonatos GD, Shuter J, Bicki A, Lloyd-Richardson EE, de Dios MA, Morrow KM, Makgoeng SB, Tashima KT, Niaura RS (2015) Outcomes of a tailored intervention for cigarette smoking cessation among Latinos living with HIV/AIDS. Nicotine Tob Res 17:975–982. CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Tucker JS, Shadel WG, Galvan FH, Naranjo D, Lopez C, Setodji C (2017) Pilot evaluation of a brief intervention to improve nicotine patch adherence among smokers living with HIV/AIDS. Psychol Addict Behav 31:148–153. CrossRefPubMedGoogle Scholar
  58. 58.
    Vidrine DJ, Arduino RC, Lazev AB, Gritz ER (2006) A randomized trial of a proactive cellular telephone intervention for smokers living with HIV/AIDS. AIDS 20:253–260. CrossRefPubMedGoogle Scholar
  59. 59.
    Vidrine DJ, Marks RM, Arduino RC, Gritz ER (2012) Efficacy of cell phone-delivered smoking cessation counseling for persons living with HIV/AIDS: 3-month outcomes. Nicotine Tob Res 14:106–110. CrossRefPubMedGoogle Scholar
  60. 60.
    Aigner CJ, Gritz ER, Tamí-Maury I, Baum GP, Arduino RC, Vidrine DJ (2017) The role of pain in quitting among human immunodeficiency virus (HIV)-positive smokers enrolled in a smoking cessation trial. Subst Abus 38:249–252. CrossRefPubMedPubMedCentralGoogle Scholar
  61. 61.
    Wewers ME, Neidig JL, Kihm KE (2000) The feasibility of a nurse-managed, peer-led tobacco cessation intervention among HIV-positive smokers. J Assoc Nurses AIDS Care 11:37–44. CrossRefPubMedGoogle Scholar
  62. 62.
    Zwiebel MA, Hughes V (2010) Smoking cessation efforts in one New York City HIV clinic. J Assoc Nurses AIDS Care 21:11–15. CrossRefPubMedGoogle Scholar
  63. 63.
    Moscou-Jackson G, Commodore-Mensah Y, Farley J, DiGiacomo M (2014) Smoking-cessation interventions in people living with HIV infection: a systematic review. J Assoc Nurses AIDS Care 25:32–45. CrossRefPubMedGoogle Scholar
  64. 64.
    U.S. Census Bureau (2016) Life off the highway: a snapshot of rural America. Accessed 14 Jan 2019
  65. 65.
    Heckman CJ, Egleston BL, Hofmann MT (2010) Efficacy of motivational interviewing for smoking cessation: a systematic review and meta-analysis. Tob Control 19:410–416. CrossRefPubMedPubMedCentralGoogle Scholar
  66. 66.
    Hettema JE, Hendricks PS (2010) Motivational interviewing for smoking cessation: a meta-analytic review. J Consult Clin Psychol 78:868–884. CrossRefPubMedGoogle Scholar
  67. 67.
    Lai DT, Cahill K, Qin Y, Tang J-L (2010) Motivational interviewing for smoking cessation. Cochrane Database Syst Rev:CD006936.
  68. 68.
    Shirley D, Thibodeau L, Catz SL, McCoy K, Jorenby DE, Safdar N, Sosman JM (2018) Cessation-related information, motivation, and behavioral skills in smokers living with HIV. AIDS Care 30:131–139. CrossRefPubMedGoogle Scholar

Copyright information

© American Association for Cancer Education 2019

Authors and Affiliations

  • Lilli Mann-Jackson
    • 1
    • 2
    Email author
  • David Choi
    • 3
  • Erin L. Sutfin
    • 1
  • Eunyoung Y. Song
    • 1
  • Kristie L. Foley
    • 1
  • Aimee M. Wilkin
    • 1
  • Caryn G. Morse
    • 1
  • Nicole F. Rojas
    • 1
  • Timothy S. Oh
    • 1
  • Scott D. Rhodes
    • 1
    • 2
  1. 1.Wake Forest School of MedicineMedical Center BoulevardWinston-SalemUSA
  2. 2.Wake Forest Clinical and Translational Science Institute Program in Community EngagementMedical Center BoulevardWinston-SalemUSA
  3. 3.Stanford UniversityPalo AltoUSA

Personalised recommendations