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RecruitingNCT05487807Quit4LifeUpdated Nov 28, 2023

Adapting and Evaluating a Tobacco Use Cessation Program for People Living With HIV in Uganda and Zambia

A Phase 1 interventional study of Nicotine patch and text messaging in Nicotine Dependence and Tobacco Dependence, sponsored by University of Southern California. Recruiting at 2 sites in 2 countries. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-11-28.

Sponsored by University of Southern California · Phase 1, Interventional, and Treatment

Phase
Phase 1
Study type
Interventional
Enrollment
800
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This proposal tests the efficacy of a phone-based tobacco cessation intervention for people living with HIV (PLWH) in comparison to the standard of care (brief advice to quit) and nicotine replacement therapy (nicotine patches) in Uganda and Zambia. This study will provide insight into the efficacy, feasibility, applicability, and affordability of delivering tobacco cessation interventions through health care professionals at HIV treatment centers in two countries with different tobacco use patterns, policy environments, and health care resources. The previously tested SMS-platform to be used in this study is uniquely positioned to be scaled in low- and middle-income countries worldwide, in which case rigorous research showing even modest success in reducing the prevalence of tobacco consumption among PLWH could confer substantial health and economic benefits.

Read the detailed description

While there is substantial evidence supporting interventions to help tobacco users in the general population quit, little is available relevant to the challenges facing HIV+ tobacco users, especially those living in low-income African countries. This study approaches this gap with the first randomized control trial (RCT) to test the efficacy of a tailored short message service (SMS) based tobacco use cessation intervention on prolonged tobacco use abstinence at 6 months post program initiation in comparison to the standard of care (brief advice to quit) and nicotine replacement therapy (nicotine patches) among PLWH in Uganda and Zambia. This study will provide insight into the efficacy, feasibility, applicability, and affordability of delivering tobacco cessation interventions through health care professionals at HIV treatment centers in two countries with different tobacco use patterns, policy environments, and health care resources and provide needed information to providers and policymakers looking for cost-effective tobacco cessation interventions.

02

Conditions studied

  • Nicotine Dependence
  • Tobacco Dependence

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03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Eligibility criteria

Inclusion Criteria:

-

Exclusion Criteria:

  • Females who are pregnant, planning to get pregnant, or breastfeeding
  • \<18 years (underage of consent)
  • Visitor, not receiving continuous care at study site
  • Not a current daily tobacco user
  • Any physical, cognitive, or psychological disabilities that would prevent them from participating in the study
  • Illiterate in English and/or local languages
  • Does not consent
04

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
800 participants (estimated)

Study arms

  • No intervention
    Standard of Care

    This is the baseline group receiving advice to quit.

  • Active comparator
    Nicotine Replacement

    This group will receive the standard of care and be prescribed nicotine replacement therapy

    Drug: Nicotine patch

  • Active comparator
    Text Messaging

    This group will receive the standard of care and receive text message support

    Behavioral: text messaging

  • Active comparator
    Nicotine replacement and text messaging

    This group will receive the standard of care, be prescribed nicotine replacement therapy, and receive text message support

    Drug: Nicotine patch · Behavioral: text messaging

Interventions

  • DrugNicotine patch

    Will be receiving nicotine therapy

    Also known as: NicoDerm

  • Behavioraltext messaging

    Will be enrolled in an texting app

    Also known as: Text2Quit

05

What researchers measure

Primary outcomes

  1. Prolonged tobacco abstinence

    The primary outcome for this efficacy trial is the proportion of study participants that have prolonged abstinence (i.e., no tobacco use from the target quit date through follow-up) at 3 and 6 months post enrollment measured by self-report and biochemically-verified as recommended by the Society for Research on Nicotine and Tobacco, the biomarker being assessed is urinary cotinine (\<12 ng/mL) at 6 months post enrollment

    Time frame: 6 months post enrollment

Secondary outcomes

  1. Point Prevalence

    7 consecutive days of no tobacco use, biochemically-verified at 4 weeks, 8 weeks, and 3 months post enrollment, the biomarker being assessed is urinary cotinine (\<12 ng/mL) at 6 months post enrollment, the measurement tool is urine cotinine dip sticks

    Time frame: 4 weeks, 8 weeks, and 3 months post enrollment

Other outcomes

  1. Quit attempts

    Self-reported quit attempts and changes in tobacco use, monitoring survey, health assessment form

    Time frame: 4 weeks, 8 weeks, and 3 months post enrollment

  2. Nicotine patch adherence

    Self-reported adherence to nicotine patch treatment, monitoring survey, health assessment form

    Time frame: 4 weeks, 8 weeks, and 3 months post enrollment

06

Study locations

2 of 2 sites recruiting
  • Makerere University
    Kampala, Uganda
    • Jim Arinaitwe, MBcHB, MPH · Contact · arinaitwej@ctc-africa.org · 256772404985
    • Anthony Mbonye, PhD · Sub investigator
    • Eizeus Rutebemberwa, MD, PhD · Sub investigator
    • David Guwatudde, Bstat,MCs, PhD · Sub investigator
    • Lynn Atuyambe, PhD · Sub investigator
    • Fred Wabwire Mangen, MBChB, MPH, PhD · Sub investigator
    Recruiting
  • University of Zambia
    Lusaka, Zambia
    • Fastone Goma, BSc, MB ChB, Mac, PhD · Contact · gomafm@yahoo.co.uk · 260977772301
    • Cosmas Zyambo, BSc MB ChB MPhi PhD · Sub investigator
    • Richard Zulu, BA MA MPhil · Sub investigator
    Recruiting
07

References and documents

Publications

  • Lifson AR, Neuhaus J, Arribas JR, van den Berg-Wolf M, Labriola AM, Read TR; INSIGHT SMART Study Group. Smoking-related health risks among persons with HIV in the Strategies for Management of Antiretroviral Therapy clinical trial. Am J Public Health. 2010 Oct;100(10):1896-903. doi: 10.2105/AJPH.2009.188664. Epub 2010 Aug 19. PubMed 20724677 ↗
  • Jackson-Morris A, Fujiwara PI, Pevzner E. Clearing the smoke around the TB-HIV syndemic: smoking as a critical issue for TB and HIV treatment and care. Int J Tuberc Lung Dis. 2015 Sep;19(9):1003-6. doi: 10.5588/ijtld.14.0813. PubMed 26260816 ↗
  • Murphy JD, Liu B, Parascandola M. Smoking and HIV in Sub-Saharan Africa: A 25-Country Analysis of the Demographic Health Surveys. Nicotine Tob Res. 2019 Jul 17;21(8):1093-1102. doi: 10.1093/ntr/nty176. PubMed 30165688 ↗
  • Mitton JA, North CM, Muyanja D, Okello S, Vorechovska D, Kakuhikire B, Tsai AC, Siedner MJ. Smoking cessation after engagement in HIV care in rural Uganda. AIDS Care. 2018 Dec;30(12):1622-1629. doi: 10.1080/09540121.2018.1484070. Epub 2018 Jun 7. PubMed 29879856 ↗
  • Kruse C, Betancourt J, Ortiz S, Valdes Luna SM, Bamrah IK, Segovia N. Barriers to the Use of Mobile Health in Improving Health Outcomes in Developing Countries: Systematic Review. J Med Internet Res. 2019 Oct 9;21(10):e13263. doi: 10.2196/13263. PubMed 31593543 ↗
  • Kruse GR, Bangsberg DR, Hahn JA, Haberer JE, Hunt PW, Muzoora C, Bennett JP, Martin JN, Rigotti NA. Tobacco use among adults initiating treatment for HIV infection in rural Uganda. AIDS Behav. 2014 Jul;18(7):1381-9. doi: 10.1007/s10461-014-0737-8. PubMed 24638166 ↗
  • Hughes JR, Keely JP, Niaura RS, Ossip-Klein DJ, Richmond RL, Swan GE. Measures of abstinence in clinical trials: issues and recommendations. Nicotine Tob Res. 2003 Feb;5(1):13-25. Erratum In: Nicotine Tob Res. 2003 Aug;5(4):603. PubMed 12745503 ↗
  • Baisley K, Baeten JM, Hughes JP, Donnell DJ, Wang J, Hayes R, Watson Jones D, Celum C. Summary measures of adherence using pill counts in two HIV prevention trials: the need for standardisation in reporting. AIDS Behav. 2013 Nov;17(9):3108-19. doi: 10.1007/s10461-013-0542-9. PubMed 23801018 ↗
  • Schnoll RA, Patterson F, Wileyto EP, Heitjan DF, Shields AE, Asch DA, Lerman C. Effectiveness of extended-duration transdermal nicotine therapy: a randomized trial. Ann Intern Med. 2010 Feb 2;152(3):144-51. doi: 10.7326/0003-4819-152-3-201002020-00005. PubMed 20124230 ↗

Individual participant data

Plan to share: No — Our dissemination strategy will target tobacco and HIV stakeholders including Ministry of Health and other government officials, health care organizations, health facility managers, HIV health care providers, tobacco control professionals, non-governmental organizations engaged in HIV and tobacco control, and PLWH. Our investigators will publish study results through peer-reviewed journals and scientific conferences; generate fact sheets and policy briefs; and disseminate our results through websites, social media, television and radio. We will share the study results in the participating Districts and the Cancer Treatments Centers of America will host a workshop in the final year with regional stakeholders to share the study results and promote tobacco use cessation programming for PLWH throughout Sub-saharan Africa. World Health Organization will assist in disseminating the study findings to other low/middle income countries.

08

Registry details

Key details

Study ID
NCT05487807
Lead sponsor
University of Southern California
Collaborators
National Cancer Institute (NCI)
Responsible party
Heather Wipfli (Associate Professor, University of Southern California) — Principal investigator
First posted
Aug 4, 2022
Start date
Sep 13, 2023
Primary completion
Aug 31, 2025 (estimated)
Completion
Aug 31, 2026 (estimated)
Last update
Nov 28, 2023

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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