Smoking cessation among HIV-positive individuals represents a critical but understudied public health challenge, with this population facing double the tobacco-related mortality risk of the general population. This Vietnamese trial offers the first robust evidence for effective cessation strategies specifically tailored to people living with HIV in resource-limited settings.
The pragmatic randomized controlled trial across 13 Hanoi HIV clinics tested three escalating interventions among daily smokers: national quitline referral alone, nurse-delivered counseling plus text messaging, and the combined approach with six weeks of nicotine replacement therapy. The most intensive intervention achieved significantly higher abstinence rates, demonstrating that comprehensive support can overcome the unique barriers HIV patients face in quitting tobacco.
This finding addresses a critical gap in HIV care, where tobacco use often receives less attention than viral suppression despite causing more deaths in well-treated HIV populations. The success of nurse-delivered interventions is particularly noteworthy, suggesting that cessation support can be effectively integrated into existing HIV care infrastructure without requiring specialized addiction specialists. The text messaging component represents an innovative adaptation to Vietnamese healthcare delivery, leveraging mobile technology for sustained behavioral support.
However, the single-country setting and relatively short follow-up period limit broader generalizability. The study's pragmatic design, while strengthening real-world applicability, may have introduced variability in intervention delivery. Most importantly, this research establishes that people living with HIV can achieve meaningful smoking cessation when provided comprehensive, tailored support that addresses both the behavioral and pharmacological aspects of nicotine addiction.