A qualitative study of the feasibility and acceptability of a smoking cessation program for people living with HIV and emotional dysregulation

A K Labbe; J G Wilner; J N Coleman; S M Marquez; J D Kosiba; M J Zvolensky; J A J Smits; P J Norton; D Rosenfield; C O'Cleirigh

doi:10.1080/09540121.2018.1533225

A qualitative study of the feasibility and acceptability of a smoking cessation program for people living with HIV and emotional dysregulation

AIDS Care. 2019 May;31(5):609-615. doi: 10.1080/09540121.2018.1533225. Epub 2018 Oct 23.

Authors

A K Labbe¹, J G Wilner², J N Coleman³, S M Marquez⁴, J D Kosiba⁵, M J Zvolensky⁶, J A J Smits⁷, P J Norton⁶, D Rosenfield⁸, C O'Cleirigh^{1

4}

Affiliations

¹ a Dept. of Psychiatry , Massachusetts General Hospital , Boston , MA , USA.
² b Dept. of Psychology , Boston University , Boston , MA , USA.
³ c Dept. of Psychology , Duke University , Raleigh , NC , USA.
⁴ d The Fenway Institute , Fenway Health , Boston , MA , USA.
⁵ e Dept. of Psychology , Syracuse University , Syracuse , NY , USA.
⁶ f Dept. of Psychology , University of Houston , Houston , TX , USA.
⁷ g Dept. of Psychology , University of Texas at Austin , Austin , TX , USA.
⁸ h Dept. of Psychology , Southern Methodist University , Dallas , TX , USA.

Abstract

Despite high rates of co-occurring tobacco use and anxiety among persons living with HIV, evidence-based interventions for these individuals are limited. An existing cognitive-behavioral treatment protocol for smoking cessation and anxiety (Norton, P. J., & Barrera, T. L. (2012). Transdiagnostic versus diagnosis-specific CBT for anxiety disorders: A preliminary randomized controlled noninferiority trial. Depression and Anxiety, 29(10), 874-882. https://doi.org/10.1002/da.21974) was modified to address transdiagnostic constructs, such as anxiety sensitivity, distress tolerance, and depressive symptomatology (Labbe, A. K., Wilner, J. G., Kosiba, J. D., Gonzalez, A., Smits, J. A., Zvolensky, M. J., … O'Cleirigh, C. (2017). Demonstration of an Integrated Treatment for Smoking Cessation and Anxiety Symptoms in People with HIV: A Clinical Case Study. Cognitive and Behavioral Practice, 24(2), 200-214. https://doi.org/10.1016/j.cbpra.2016.03.009). This study examines the feasibility and acceptability of the intervention as determined from qualitative data from structured exit interviews from 10 participants who completed treatment. Results demonstrated that participants were very motivated to quit smoking and enrolled in the program for health-related reasons and to be able to quit. Participants found nearly all the treatment components to be useful for reaching their smoking cessation goal and in managing emotional dysregulation. Last, all participants stated that they would strongly recommend the treatment program. This qualitative study provides initial evidence for the feasibility and acceptability of a modified smoking cessation treatment protocol for HIV+ individuals with anxiety and emotional dysregulation. Future research will focus on evaluating the efficacy of the protocol in a full-scale randomized controlled trial, as well as working to collect qualitative data from participants who discontinue treatment to better understand reasons for treatment attrition.

Keywords: HIV; anxiety; cognitive–behavioral therapy; emotional dysregulation; smoking cessation.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adult
Anxiety / psychology*
Cognitive Behavioral Therapy / methods*
Depression / psychology*
Emotions*
Feasibility Studies
Female
HIV Infections / complications
HIV Infections / psychology
HIV Infections / therapy*
Humans
Male
Motivation
Patient Acceptance of Health Care*
Qualitative Research
Randomized Controlled Trials as Topic
Smoking / adverse effects*
Smoking / psychology
Smoking Cessation / psychology*
Young Adult

Grants and funding

R34 DA031038/DA/NIDA NIH HHS/United States