Please select the eligibility criteria that correspond to the clinical trial below.
Title: Improving Adherence to Smoking Cessation Medication Among PLWHA
Brief Summary: Smoking rates among individuals living with HIV/AIDS range between 47% and 65%, a prevalence that is roughly three times the rate of the general population. This elevated prevalence is alarming given the increased likelihood of numerous adverse health outcomes experienced by HIV-positive smokers. Cigarette smoking is associated with greater levels of HIV-related symptom burden and appears to decrease the effectiveness of HAART as assessed by both viral load and CD4 counts (Vidrine 2009, Marshall 2009, Vidrine 2007, Miguez-Burbane 2005). PLWHA who smoke are also at increased risk of infections and noninfectious pulmonary complications and both AIDS-associated and non-AIDS-associated malignancies compared to nonsmokers. This study will refine and pilot test a theory-driven smoking cessation intervention that enhances existing behavioral approaches by testing the impact of text message reminders to take varenicline and the feasibility and additional impact of including adherence-focused behavioral cessation counseling. The investigators propose to randomize 190 participants, recruited from three HIV/AIDS clinic, to a three arm pilot study that compares: 1) Standard Care (SC), 2) SC + text message reminders, and 3) SC + text message reminders + cell phone-delivered adherence-focused behavioral therapy (ABT). Participants in all three arms will receive varenicline for 12 weeks. The primary outcomes are adherence to varenicline and biochemically validated smoking abstinence at 12 weeks and 3-month follow-up from the time of study enrollment.


Options:
A: Inclusion Criteria:

* Smoke 5+ cigarettes/day
* \< 3 months abstinence in the past year
* Have a smartphone
* Score greater than or equal to 8 of 10 on the Contemplation Ladder (Biener \& Abrams, 1991)

Exclusion Criteria:

* None
B: Inclusion Criteria:

1. Current patient at one of two SLR CCC clinics with a designated physician (had intake visit and enrolled into clinic)
2. Age 18 years or older;
3. Current or regular smoker (\>5 cigarettes per day);
4. Carbon Monoxide (CO) monitor reading of \>8 ppm;
5. Willingness to set a quit date;
6. Able to conduct activities in English;
7. Ability to provide informed consent;
8. Willingness to carry/use a cell phone; AND
9. Eligible to take varenicline as determined by the patient's primary care provider

Exclusion Criteria:

1. Unstable cardiovascular disease (e.g. uncontrolled blood pressure, unstable angina, or myocardial infarction in the past 4 weeks);
2. Current homicidal or suicidal ideation, history of suicidal ideation, or history of psychosis;
3. Has a serious or untreated psychiatric illness (major depression, bipolar or schizophrenia);
4. Severe renal impairment (defined as having a creatinine clearance \< 30mL/min);
5. Currently using smokeless tobacco;
6. Currently using FDA-approved smoking cessation medication or other smoking cessation treatment and or participating in another smoking cessation program;
7. Active drug use identified by a score of 6 or above on DAST-10 Drug Abuse Screening Test;
8. Alcohol dependence or risk drinking identified by a score of 5 or above for men and 4 or above for women on AUDIT-C Alcohol Use Disorders Identification Test
9. Pregnant or nursing; AND/OR
10. Has a cognitive impairment that would preclude giving consent.
C: Inclusion Criteria:

* must have smoked 100 cigarettes during their lifetime
* must currently smoke 5 or more cigarettes a day
* must be in the preparation stage of quitting smoking
* ages 18-59 years
* English speaking
* have a mobile phone with an unlimited texting plan and internet access
* use text messaging at least once a week
* use Facebook daily
* have an active email account
* live in the continental USA

Exclusion Criteria:

* a medical condition that is contra-indicated for nicotine replacement therapy:
* pregnant
* breast feeding
* a recent heart attack
* an irregular heartbeat
* high blood pressure not controlled with medication
* skin allergies to adhesive tape or serious skin problems
* taking a prescription medicine for depression or anxiety
* use drugs or marijuana regularly
* live in the same household with another participant
D: Inclusion Criteria:

* ages 18-25 years old
* english literate
* have access to Smartphone or computer with camera
* indicate they go on Facebook "most" (≥ 4) days per week
* have smoked ≥100 cigarettes in their lives and currently smoke at least 1 cigarette per day on 3 or more days of the week

Exclusion Criteria:

* do not read English
* younger than 18 or older than 25 years of age
* do not have access to a Smartphone or computer with a camera
* only go on Facebook 3 or fewer days a week
* have smoked less than 100 cigarettes in their lifetime or do not currently smoke at least 1 cigarette per day on 3 or more days of the week

Answer: B