Skip to main content

Advertisement

SpringerLink
Log in

Feasibility, Acceptability, and Preliminary Effects of a Video-Based Intervention for Smoking Cessation Among People with HIV in Kathmandu, Nepal: A Single-Armed Pilot Study

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Despite the evidence of the disproportionate burden of tobacco use among people with HIV (PWH), little effort has been made to design and test smoking cessation interventions for PWH in resource-limited countries. We assessed the feasibility, acceptability, and preliminary effects of a video-based smoking cessation intervention consisting of eleven 3-8-minute sessions among PWH in Nepal, a lower-middle-income country. Guided by the phased-based model, our 3-month intervention focused on setting the quit date, smoking cessation, and abstinence maintenance. We screened 103 PWH over three weeks for our single-arm trial, with 53 considered eligible and 48 recruited (91%). Forty-six participants watched all video clips, while two watched 7–9. All participants were retained at a 3-month follow-up. The 1-week point prevalence abstinence (self-report supported with expired carbon monoxide levels < 5ppm) at 3-month follow-up was 39.6%. Most (90%) participants reported “very much” or “much” comfort with watching the videos on their smartphones, and all would recommend the intervention to other PWH who smoke. Overall, our pilot trial demonstrated the feasibility, acceptability, and high-level efficacy of the video-based smoking cessation intervention highlighting its potential for scaling up in Nepal and other resource-limited countries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data Availability

Available from authors upon request.

References

  1. Park LS, Hernández-Ramírez RU, Silverberg MJ, Crothers K, Dubrow R. Prevalence of non-HIV cancer risk factors in persons living with HIV/AIDS: a meta-analysis. AIDS. 2016;30(2):273–91. https://doi.org/10.1097/QAD.0000000000000922.

    Article  CAS  PubMed  Google Scholar 

  2. Helleberg M, May MT, Ingle SM, et al. Smoking and life expectancy among HIV-infected individuals on antiretroviral therapy in Europe and North America. AIDS. 2015;29(2):221–9. https://doi.org/10.1097/QAD.0000000000000540.

    Article  CAS  PubMed  Google Scholar 

  3. Chattopadhyay A, Caplan DJ, Slade GD, Shugars DC, Tien HC, Patton LL. Incidence of oral candidiasis and oral hairy leukoplakia in HIV-infected adults in North Carolina. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99(1):39–47. https://doi.org/10.1016/j.tripleo.2004.06.081.

    Article  PubMed  Google Scholar 

  4. Bronner Murrison L, Martinson N, Moloney RM, et al. Tobacco Smoking and Tuberculosis among Men living with HIV in Johannesburg, South Africa: a case-control study. PLoS ONE. 2016;11(11):e0167133. https://doi.org/10.1371/journal.pone.0167133.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Winstone TA, Man SFP, Hull M, Montaner JS, Sin DD. Epidemic of lung cancer in patients with HIV infection. Chest. 2013;143(2):305–14. https://doi.org/10.1378/chest.12-1699.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Reddy KP, Kong CY, Hyle EP, et al. Lung Cancer Mortality Associated with Smoking and Smoking Cessation among People living with HIV in the United States. JAMA Intern Med. 2017;177(11):1613–21. https://doi.org/10.1001/jamainternmed.2017.4349.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Abbud RA, Finegan CK, Guay LA, Rich EA. Enhanced production of human immunodeficiency virus type 1 by in vitro-infected alveolar macrophages from otherwise healthy cigarette smokers. J Infect Dis. 1995;172(3):859–63. https://doi.org/10.1093/infdis/172.3.859.

    Article  CAS  PubMed  Google Scholar 

  8. Valiathan R, Miguez MJ, Patel B, Arheart KL, Asthana D. Tobacco smoking increases immune activation and impairs T-cell function in HIV infected patients on antiretrovirals: a cross-sectional pilot study. PLoS ONE. 2014;9(5):e97698. https://doi.org/10.1371/journal.pone.0097698.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Pollack TM, Duong HT, Pham TT, Do CD, Colby D. Cigarette smoking is associated with high HIV viral load among adults presenting for antiretroviral therapy in Vietnam. PLoS ONE. 2017;12(3):e0173534. https://doi.org/10.1371/journal.pone.0173534.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. WHO. Tobacco, WHO Fact Sheet N 339. Geneva: World Health Organization; 2015;:23.

  11. UNAIDS. UNAIDS Data 2017. Geneva: Joint United Nations Programme on HIV/AIDS 2017.

  12. Parascandola M, Bloch M. The Global Laboratory of Tobacco Control: research to Advance Tobacco Cessation in LMICs. J Smok Cessat. 2016;11(2):70–7. https://doi.org/10.1017/jsc.2015.22.

    Article  Google Scholar 

  13. Maziak W, Eissenberg T, Klesges RC, Keil U, Ward KD. Adapting smoking cessation interventions for developing countries: a model for the Middle East. Int J Tuberc Lung Dis. 2004;8(4):403–13.

    CAS  PubMed  Google Scholar 

  14. Fiore MC, Baker TB et al. Jaén CR, Baker TB Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville,MD: U.S. Department of Health and Human Services. Public Health Service. May2008.;:23.

  15. Tsima BM, Moedi P, Maunge J, et al. Feasibility of implementing a novel behavioural smoking cessation intervention amongst human immunodeficiency virus-infected smokers in a resource-limited setting: a single-arm pilot trial. South Afr J HIV Med. 2020;21(1):1075. https://doi.org/10.4102/sajhivmed.v21i1.1075.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Bui TC, Sopheab H, Businelle MS, et al. Mobile-health intervention for smoking cessation among cambodian people living with HIV: a mixed-methods pilot study. AIDS Care. 2022;34(4):430–9. https://doi.org/10.1080/09540121.2021.1887443.

    Article  PubMed  Google Scholar 

  17. Bigna JJR, Noubiap JJN, Kouanfack C, Plottel CS, Koulla-Shiro S. Effect of mobile phone reminders on follow-up medical care of children exposed to or infected with HIV in Cameroon (MORE CARE): a multicentre, single-blind, factorial, randomised controlled trial. Lancet Infect Dis. 2014;14(7):600–8. https://doi.org/10.1016/S1473-3099(14)70741-8.

    Article  PubMed  Google Scholar 

  18. Ayer R, Kikuchi K, Ghimire M, et al. Clinic Attendance for antiretroviral pills Pick-Up among HIV-Positive people in Nepal: roles of Perceived Family Support and Associated factors. PLoS ONE. 2016;11(7):e0159382. https://doi.org/10.1371/journal.pone.0159382.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Poudel KC, Poudel-Tandukar K, Pandey BD, Letson E, Palmer PH. A brief tobacco dependence intervention for people living with HIV in Nepal: results of a quasi-experimental study. J Smok Cessat. 2019;14(4):221–8. https://doi.org/10.1017/jsc.2019.11.

    Article  Google Scholar 

  20. Amiya RM, Poudel KC, Poudel-Tandukar K, Kobayashi J, Pandey BD, Jimba M. Physicians are a key to encouraging cessation of smoking among people living with HIV/AIDS: a cross-sectional study in the Kathmandu Valley, Nepal. BMC Public Health. 2011;11:677. https://doi.org/10.1186/1471-2458-11-677.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Bhatta DN, Subedi A, Sharma N. Tobacco smoking and alcohol drinking among HIV infected people using antiretroviral therapy. Tob Induc Dis. 2018;16:16. https://doi.org/10.18332/tid/86716.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Gritz ER, Danysh HE, Fletcher FE, et al. Long-term outcomes of a cell phone-delivered intervention for smokers living with HIV/AIDS. Clin Infect Dis. 2013;57(4):608–15. https://doi.org/10.1093/cid/cit349.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Vidrine DJ, Marks RM, Arduino RC, Gritz ER. Efficacy of cell phone-delivered smoking cessation counseling for persons living with HIV/AIDS: 3-month outcomes. Nicotine Tob Res. 2012;14(1):106–10. https://doi.org/10.1093/ntr/ntr121.

    Article  PubMed  Google Scholar 

  24. Baker TB, Collins LM, Mermelstein R, et al. Enhancing the effectiveness of smoking treatment research: conceptual bases and progress. Addiction. 2016;111(1):107–16. https://doi.org/10.1111/add.13154.

    Article  PubMed  Google Scholar 

  25. Baker TB, Mermelstein R, Collins LM, et al. New methods for tobacco dependence treatment research. Ann Behav Med. 2011;41(2):192–207. https://doi.org/10.1007/s12160-010-9252-y.

    Article  PubMed  Google Scholar 

  26. WHO Global Observatory for EHealth. MHealth: New Horizons for Health through Mobile Technologies: Second Global Survey on EHealth. Geneva: World Health Organization; Jun 11, 2011. https://apps.who.int/iris/handle/10665/44607

  27. WHO. Addressing mobile health. Geneva: World Health Organization. Available: https://www.who.int/activities/Addressing-mobile-health. Accessed March 1, 2023. https://www.who.int/activities/Addressing-mobile-health

  28. Mobile Cellular Subscriptions (per 100 People). The World Bank. 2016. https://Data.Worldbank.Org/Indicator/IT.CEL.SETS.P2. Accessed August 2018.;:23.

  29. Ayer R, Poudel KC, Kikuchi K, Ghimire M, Shibanuma A, Jimba M. Nurse-led mobile phone Voice call reminder and On-Time antiretroviral pills Pick-Up in Nepal: a Randomized Controlled Trial. AIDS Behav. 2021;25(6):1923–34. https://doi.org/10.1007/s10461-020-03122-7.

    Article  PubMed  Google Scholar 

  30. Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO. The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict. 1991;86(9):1119–27. https://doi.org/10.1111/j.1360-0443.1991.tb01879.x.

    Article  CAS  PubMed  Google Scholar 

  31. Poudel KC, Poudel-Tandukar K, Bertone-Johnson ER, Pekow P, Vidrine DJ. Inflammation in relation to intensity and duration of cigarette smoking among people living with HIV. AIDS Behav. 2021;25(3):856–65. https://doi.org/10.1007/s10461-020-03048-0.

    Article  PubMed  Google Scholar 

  32. Benowitz NL, Bernert JT, Foulds J, et al. Biochemical Verification of Tobacco Use and abstinence: 2019 update. Nicotine Tob Res. 2020;22(7):1086–97. https://doi.org/10.1093/ntr/ntz132.

    Article  PubMed  Google Scholar 

  33. Lancaster T, Stead LF. Individual behavioural counselling for smoking cessation. Cochrane Database Syst Rev. 2017;3(3):CD001292. https://doi.org/10.1002/14651858.CD001292.pub3.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors acknowledge all the study participants for their time, information, participation, interest, and commitment to quitting tobacco. We thank the research assistants (Ms. Amrita Karki, Ms. Reshma Khatri, and Mr. Rajan Shrestha) for their tireless work in recruiting participants, conducting baseline and follow-up assessments, sending videos, monitoring session attendance, and troubleshooting problems. We sincerely acknowledge Sukraraj Tropical and Infectious Disease Hospital for permitting us to conduct this study within its HIV clinic. The authors would also like to thank Mr. Radheshyam Shrestha of the AIDS Healthcare Foundation and all the staff members of the HIV clinic for their support in recruiting the study participants and providing venues for data collection. They also acknowledge Dr. Steve Acquah, Mr. Adam Quiros, and Mr. Yuntian Hu of the Digital Media Lab of the University of Massachusetts Amherst for their assistance in developing smoking cessation videos.

Funding

This study was supported by a Faculty Research Grant from the University of Massachusetts Amherst (# P1FRG 0000000267). The production of smoking cessation videos was supported by the Dean’s Research Enhancement Award of the University of Massachusetts Amherst School of Public Health and Health Sciences. Funding agencies did not have any role in the study design; the collection, analysis, and interpretation of data; the writing of the manuscript; or the decision to submit the article for publication.

Author information

Authors and Affiliations

  1. Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, 715 North Pleasant St., Arnold House, Amherst, MA, 01003-9304, USA

    Krishna C. Poudel & Elizabeth R. Bertone-Johnson

  2. Institute for Global Health, University of Massachusetts Amherst, Amherst, MA, USA

    Krishna C. Poudel

  3. Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, MA, USA

    Kalpana Poudel-Tandukar

  4. Green Tara Nepal, Kathmandu, Nepal

    Ram Chandra Silwal

  5. Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Nepal

    Bimal Sharma Chalise

  6. Department of Biostatistics & Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA

    Elizabeth R. Bertone-Johnson

  7. Moffit Cancer Center, Department of Health Outcomes and Behavior, Tampa, FL, USA

    Damon J. Vidrine

Authors
  1. Krishna C. Poudel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kalpana Poudel-Tandukar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ram Chandra Silwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bimal Sharma Chalise
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Elizabeth R. Bertone-Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Damon J. Vidrine
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

KCP designed the study, trained the field team, supervised the fieldwork, analyzed data, and prepared the original manuscript draft. KP-T contributed to analyzing qualitative data and reviewed and edited the manuscript. RCS and BSC trained the field team, supervised the fieldwork, and reviewed and edited the manuscript. ERB-J and DJV reviewed and edited the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Krishna C. Poudel.

Ethics declarations

Competing Interests

The authors declare that they have no conflict of interest.

Consent to Participate

We obtained written informed consent from all the study participants.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Poudel, K.C., Poudel-Tandukar, K., Silwal, R.C. et al. Feasibility, Acceptability, and Preliminary Effects of a Video-Based Intervention for Smoking Cessation Among People with HIV in Kathmandu, Nepal: A Single-Armed Pilot Study. AIDS Behav 27, 3468–3477 (2023). https://doi.org/10.1007/s10461-023-04062-8

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-023-04062-8

Keywords

Search

Navigation