WeChat-based Messaging and Behavioral Counseling for Smoking Cessation for People with HIV in China: a Randomized...

Cigarette smoking among people with HIV is a leading preventable cause of morbidity and mortality, particularly in China given its immense burden of smoking. This pilot study aimed to evaluate the feasibility, acceptability, and efficacy on smoking cessation of a community-informed WeChat-based messaging and behavioral counseling intervention for people with HIV who smoke called Quit for Life. The study design was a 2-group randomized clinical trial. Data collection occurred between February 2022 and August 2023 within a tertiary infectious disease hospital in Nanning city, Guangxi, China. Participants included adults with HIV who smoked, were willing to set a quit date, and received HIV care at the hospital. Participants were randomized to the 8-week Quit for Life intervention group (nicotine replacement therapy gum, self-help quitting smoking guide, behavioral counseling, and WeChat-based messaging), or the control group (nicotine replacement therapy gum and self-help guide only). Complete case analysis was performed. Of 219 people assessed for eligibility, 109 participants were randomized (mean [SD] age, 45.3 [15.1] years; men [96.3%]) and 98 completed the 12-week assessment (89.9% retention rate). At 12-week follow-up, the biochemically verified smoking cessation rate (primary outcome) was significantly higher in the intervention group compared to the control group (59.1% abstinence vs. 25.6%, adjusted odds ratio 5.3 [1.5,19.2]. Implementation and feasibility metrics indicated most participants receiving the intervention as intended gave high ratings of the usefulness of counseling sessions and WeChat-based messaging. Given these findings, subsequent studies should investigate implementation and scale-up of this intervention for people with HIV in China.Clinical trial registration details: Trial registration number: ClinicalTrials.gov Identifier: NCT05020899. Date of trial registration: 8-19-2021.