# Varenicline and mobile behavioral assistance for tobacco cessation in HIV care in India

> **NIH NIH U01** · UNIVERSITY OF COLORADO DENVER · 2023 · $150,247

## Abstract

Abstract
There is an urgent need to implement effective tobacco cessation interventions in HIV care programs in low-
and middle-income countries (LMICs) where most tobacco users and people with HIV live. India is an
important setting in which to test tobacco cessation interventions with an estimated 275 million tobacco users
and 2 million people living with HIV (PWH). Effective medications and behavioral interventions have not been
well tested in HIV care settings in LMICs. In high income settings, Positively Smoke Free (PSF), a theory-
based behavioral intervention, has demonstrated efficacy among PWH and been adapted for mobile phone
delivery (PSF-M). Mobile health interventions offer scalability and may be more effective among PWH than
face-to-face. Varenicline is the cessation medication with the strongest evidence of efficacy in PWH but
achieving sufficient adherence to sustain long-term success is a challenge. We propose to combine the two
most promising cessation interventions among PWH, varenicline and PSF-M, enhanced with varenicline
adherence support. They will be tested at the Voluntary Health Services (VHS) Infectious Disease Medical
Center, Chennai Antiviral Research and Treatment Clinical Research Site, where 24% of patients new to HIV
care are current smokers or dual users of smoked and smokeless tobacco and 83% own mobile phones. In
this setting we propose the following specific aims: (1) To demonstrate the effectiveness of an integrated
intervention combining varenicline plus mobile behavioral treatment among tobacco users in HIV care on
biochemically verified tobacco abstinence at 24 weeks compared to a standard care control; (2): To evaluate
the implementation processes of the integrated intervention in an LMIC HIV practice; and (3): To measure the
costs and cost-effectiveness of an integrated intervention with varenicline and PSF-M. To accomplish these
aims, PSF-M will be adapted to the VHS context and novel content about smokeless tobacco and medication
adherence self-efficacy will be added. A randomized two-arm trial will compare the combination of varenicline
and PSF-M to a standard care control. We will evaluate implementation processes within HIV care workflows
including acceptability, appropriateness, feasibility and costs and conduct cost-effectiveness analysis to assess
the clinical impact and value of the integrated intervention if scaled-up. The work proposed is responsive to the
specific interests in RFA-CA-20-037 by testing the effectiveness of tobacco cessation interventions with
demonstrated efficacy in other settings and adapted for an LMIC context, evaluating the implementation
process from multiple stakeholder perspectives in an HIV care practice, and assessing the clinical impact and
value of the integrated intervention if implemented at scale. The successful completion of this work will move
the field forward by advancing our understanding of the effectiveness of an integrated tobacco cessation
intervention ...

## Key facts

- **NIH application ID:** 10908792
- **Project number:** 3U01CA261614-04S1
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Gina Rae Kruse
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $150,247
- **Award type:** 3
- **Project period:** 2021-09-23 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10908792

## Citation

> US National Institutes of Health, RePORTER application 10908792, Varenicline and mobile behavioral assistance for tobacco cessation in HIV care in India (3U01CA261614-04S1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10908792. Licensed CC0.

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