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Study Finds Smoking Cessation Leads to Improved Quality of Life

By Liz Highleyman

Although tobacco smoking does not appear to lead to higher HIV viral loads or lower CD4 cell counts, smokers are more likely to develop certain opportunistic illnesses, especially Pneumocystis pneumonia (PCP). Smoking may also lead to more frequent and severe symptoms and lower quality of life, according to a study reported in the September 2007 issue of AIDS Patient Care and STDs.

Researchers from the University of Texas at Houston studied the effects of changes in smoking habits on HIV-related symptoms and health-related quality of life (HRQOL) in 95 low-income patients of diverse race/ethnicity (about 75% African American) at an inner city HIV/AIDS clinic enrolled in a smoking cessation trial.

All participants received a medical consultation about smoking cessation, nicotine replacement therapy, and written materials; in addition, some were randomly assigned to also receive more intensive counseling by mobile phone and a hotline. Data were analyzed for the 77 participants who completed 3 months of follow up

Biochemically verified smoking status in the past 24 hours, self-reported length of smoking abstinence, HIV-related symptom burden, and HRQOL were assessed 3 months after enrollment. Multiple linear regression was performed to assess associations between smoking status and health outcomes at follow-up while controlling for baseline levels.

Results

• After 3 months, 23% of participants had verified 24-hour abstinence and reported an average smoke-free period of 21 days.

• About 37% reported abstaining from smoking for 30 days or longer.

• Subjects who received phone counseling were more likely to have verified 24-hour abstinence (37% vs 10%) and a longer smoke-free period (31 vs 12 days) than those who did not.

• Length of smoking abstinence was significantly associated with HIV-related symptom burden (P = 0.02).

• Specifically, an increasing number of consecutive days without smoking during the 3-month follow-up period was associated with lower levels of HIV-related symptoms.

• However, 24-hour smoking prevalence was not significantly associated with changes in either HIV-related symptom burden or HRQOL (P > 0.05).

Conclusion

"These findings suggest that smoking cessation can significantly improve symptom burden for individuals living with HIV/AIDS," the study authors wrote. "Moreover, these benefits are observable as early as 3 months after quitting and are positively correlated with the length of abstinence."

While improvements in HRQOL were apparent after an average abstinence period of 3 weeks, they were not associated with 24-hour abstinence, possibly because quality of life may be diminished during the first several days after quitting (the period of nicotine withdrawal), before it improves. Therefore, the authors suggested, it may take some time before the benefits of smoking cessation are realized.

10/16/07

Reference
DJ Vidrine, RC Arduino, ER Gritz. The Effects of Smoking Abstinence on Symptom Burden and Quality of Life Among Persons Living with HIV/AIDS. AIDS Patient Care and STDs. 21(9): 659-66. September 2007.