Grant: Operating Grant

With newer antiretroviral therapy (ART), people living with HIV/AIDS (PHAs) have greater life expectancies. However, in aging with HIV, new problems have emerged for PHAs such as increased heart disease. PHAs are much more likely to have a heart attack compared to non-PHAs. While the reasons for this are complex, a leading cause of heart disease is cigarette smoking and nearly half of all PHAs smoke cigarettes. Quitting smoking is very difficult for most people. For smokers who are also experiencing depression, smoking relapse rates are much higher. Since nearly 50% of all PHAs report symptoms of depression, it is not surprising that many PHAs have trouble with quitting smoking. To date, little research has examined methods to help PHAs stop smoking. This exciting research proposal brings together a dynamic multi-disciplinary team of Canadian researchers who will directly evaluate different strategies to determine the most helpful method to assist PHAs quit smoking and to "stay quit". Two hundred and fifty-six PHAs recruited from HIV clinics across Canada will be randomly distributed into one of four groups: (i) varenicline (a medication which helps reduce cravings for nicotine) with counseling designed to address HIV and depression; (ii) varenicline with standard care; (iii) the nicotine patch with counseling designed to address HIV and depression; or (iv) the nicotine patch with standard care. We will then evaluate which of these strategies is most helpful. After antiretroviral therapy, quitting smoking is likely the single most effective way to improve quality of life and to reduce smoking-related illnesses such as heart disease, stroke, lung disease, and cancer among PHAs. We believe that our proposed bilingual "Canadian HIV Quit Smoking study" will provide a significant contribution towards promoting physical and mental well-being and quality of life among PHAs across Canada.