Smoking represents an important health threat to persons living with HIV/AIDS (PLWHA), yet few efforts to develop, deliver and evaluate cessation interventions appear in the literature. To address this gap, we conducted an RCT to compare a cell phone-based intervention (CPI) to usual care (UC). UC participants received brief provider advice to quit, self-help materials and access to NRT. CPI participants received all UC components plus a cell phone, by which proactive counseling was delivered. Smoking status, biochemically verified by expired CO, was determined at 3-, 6-, and 12-month follow-ups. Four-hundred-seventy-four participants were enrolled and randomized (236 in CPI and 238 in UC). The treatment groups were well-balanced in terms of socio-demographic and behavioral characteristics. Using an intent-to-treat approach, multiple logistic regression modeling was used to estimate the effect of treatment group on abstinence at the time of each follow-up. At 3-months, ORs (95% CI) were 4.2 (2.1, 8.4) for 24-hour abstinence; 4.3 (1.9, 9.8) for 7-day; 3.6 (1.5, 8.6) for 30-day; and 5.2 (1.9, 14.2) for continuous abstinence. At 6-months, ORs (95% CI) were 1.4 (0.7, 2.9) for 24 hour abstinence; 1.2 (0.5, 2.9) for 7-day; 1.5 (0.6, 4.1) for 30-day and 1.9 (0.5, 6.5) for continuous abstinence. At 12-months, ORs (95% CI) were 0.7 (0.4, 1.5) for 24 hour abstinence; 0.6 (0.2, 1.4) for 7-day; 0.5 (0.2, 1.4) for 30-day and 0.5 (0.2, 1.4) for continuous abstinence. Preliminary generalized linear mixed models were generated to estimate the treatment group effect on abstinence outcomes over all follow-ups. Results indicated participants who received the CPI were significantly more likely to have achieved 24 hour abstinence (p=0.01) and continuous abstinence (p=0.048). However, the effects of CPI on 7-day abstinence (p=0.06) and 30-day abstinence (p=0.10) were marginally non-significant. While the 3-month findings are positive and indicate that PLWHA can achieve significantly higher abstinence rates with a CPI treatment approach, findings from the 6- and 12-month follow-ups suggest that treatment refinements are needed to achieve longer term abstinence.
