# Clinical and Economic Outcomes of HIV, Cigarette Smoking, and Smoking Cessation Interventions

> **NIH NIH K01** · MASSACHUSETTS GENERAL HOSPITAL · 2020 · $186,192

## Abstract

Project Summary
The prevalence of cigarette smoking among people living with HIV (PLWH) in the US is about double that
among the general population. Tobacco and HIV may act synergistically to increase morbidity and mortality
risks. Among PLWH on antiretroviral therapy (ART), smoking now reduces life expectancy more than HIV
itself. The footprint of smoking will likely grow as PLWH age.
Compared to the general population, PLWH have been less likely to quit smoking. Smoking cessation
interventions have not been widely implemented in HIV care, partly due to the lack of guidance for patients and
care providers on the optimum cessation strategies in this population. While improvements in HIV care have
largely been focused on novel antiretroviral drug regimens, there is still much to be accomplished in reducing
the burden of smoking-attributable disease. In an environment of growing attention to resource utilization,
where annual ART costs exceed $30,000 per patient, evaluating the cost-effectiveness of smoking cessation
interventions in promoting abstinence and reducing the toll of smoking is critically important.
I am a pulmonologist with a background in economics and prior experience in HIV and tuberculosis research. I
am motivated to investigate efficient ways to reduce the burden of disease caused by smoking and HIV.
Simulation modeling can project long-term clinical and economic outcomes of behaviors, diseases, and
interventions. My long-term goal is to become a world expert on the application of evidence- and model-based
approaches to clinical decision-making and public health policy at the intersection of tobacco, HIV, and lung
disease. In my recent research training, I have learned the fundamentals of disease simulation via a validated
and widely-published computer simulation of HIV natural history and outcomes, the Cost-Effectiveness of
Preventing AIDS Complications (CEPAC)-US model.
To achieve independence, I require further training in: 1) modeling complex health behaviors; 2) deriving
clinical and economic outcome data; and 3) designing and conducting cost-effectiveness analysis. To enhance
my methodologic skills in these areas, I have outlined a plan of didactic coursework and assembled a
multidisciplinary mentorship team. My primary mentor is Dr. Rochelle Walensky, an expert in HIV outcomes
research and modeling, and my co-mentor is Dr. Nancy Rigotti, an international authority in tobacco cessation
interventions and control policy. My mentorship team additionally includes experts in behavioral science (Park),
comorbidities in PLWH (Triant), lung disease epidemiology (Christiani), chronic obstructive pulmonary disease
in PLWH (Medoff), applied epidemiology and biostatistics (Parker), resource utilization and health economics
(Resch), mathematical modeling and cost-effectiveness analysis (Weinstein and Paltiel), and HIV outcomes
and policy (Freedberg). With their guidance, I will leverage the CEPAC-US model to achieve the following
specifi...

## Key facts

- **NIH application ID:** 9981711
- **Project number:** 5K01DA042687-05
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Krishna P Reddy
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $186,192
- **Award type:** 5
- **Project period:** 2016-09-01 → 2022-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9981711

## Citation

> US National Institutes of Health, RePORTER application 9981711, Clinical and Economic Outcomes of HIV, Cigarette Smoking, and Smoking Cessation Interventions (5K01DA042687-05). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/9981711. Licensed CC0.

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