Predicting smoking cessation and its relapse in HIV-infected patients: the Swiss HIV Cohort Study

Schäfer, J.; Young, J.; Bernasconi, E.; Ledergerber, B.; Nicca, D.; Calmy, A.; Cavassini, M.; Furrer, H.; Battegay, M.; Bucher, H. C. (2014). Predicting smoking cessation and its relapse in HIV-infected patients: the Swiss HIV Cohort Study. HIV medicine, 16(1), pp. 3-14. Blackwell Science 10.1111/hiv.12165

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OBJECTIVES: The aim of the study was to assess whether prospective follow-up data within the Swiss HIV Cohort Study can be used to predict patients who stop smoking; or among smokers who stop, those who start smoking again. METHODS: We built prediction models first using clinical reasoning ('clinical models') and then by selecting from numerous candidate predictors using advanced statistical methods ('statistical models'). Our clinical models were based on literature that suggests that motivation drives smoking cessation, while dependence drives relapse in those attempting to stop. Our statistical models were based on automatic variable selection using additive logistic regression with component-wise gradient boosting. RESULTS: Of 4833 smokers, 26% stopped smoking, at least temporarily; because among those who stopped, 48% started smoking again. The predictive performance of our clinical and statistical models was modest. A basic clinical model for cessation, with patients classified into three motivational groups, was nearly as discriminatory as a constrained statistical model with just the most important predictors (the ratio of nonsmoking visits to total visits, alcohol or drug dependence, psychiatric comorbidities, recent hospitalization and age). A basic clinical model for relapse, based on the maximum number of cigarettes per day prior to stopping, was not as discriminatory as a constrained statistical model with just the ratio of nonsmoking visits to total visits. CONCLUSIONS: Predicting smoking cessation and relapse is difficult, so that simple models are nearly as discriminatory as complex ones. Patients with a history of attempting to stop and those known to have stopped recently are the best candidates for an intervention.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Furrer, Hansjakob

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1464-2662

Publisher:

Blackwell Science

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

06 Oct 2014 15:12

Last Modified:

26 Jun 2016 01:52

Publisher DOI:

10.1111/hiv.12165

PubMed ID:

24809704

Uncontrolled Keywords:

HIV, relapse, smoking cessation

BORIS DOI:

10.7892/boris.52506

URI:

https://boris.unibe.ch/id/eprint/52506

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