Clinical Takeaway
A digital therapeutic tailored specifically for people living with HIV showed strong feasibility and acceptability as a smoking cessation tool, suggesting this population can be effectively reached through app-based interventions. Tobacco use remains a leading driver of illness and death among people with HIV, making scalable cessation tools a clinical priority.
#22 Population reach, feasibility and acceptability of digital therapeutics for smoking cessation among people living with HIV: Results of the Quitting Matters pilot trial.
Citation: Vilardaga R et al.. Population reach, feasibility and acceptability of digital therapeutics for smoking cessation among people living with HIV: Results of the Quitting Matters pilot trial.. Drug and alcohol dependence. 2026. PMID: 41512654.
Design: 5 Journal: 0 N: 1 Recency: 3 Pop: 2 Human: 1 Risk: -2
Digital therapeutics present a scalable intervention strategy to address the disproportionate burden of tobacco-related morbidity and mortality in people living with HIV, a population historically underserved by conventional smoking cessation programs. This pilot trial provides critical feasibility and acceptability data necessary to determine whether DTx-based approaches can achieve meaningful population reach and engagement in HIV care settings. The findings directly inform whether digital platforms can be incorporated into existing HIV care workflows to improve smoking cessation outcomes and reduce preventable disease burden in this high-risk population.
Quality Gate Alerts:
- Preclinical only
Abstract: INTRODUCTION: Tobacco use is disproportionately prevalent among people living with HIV (PWH) and is a significant contributor to morbidity and mortality in this population. Reaching communities of PWH to facilitate smoking cessation is challenging. Digital Therapeutics (DTx) can facilitate widespread implementation and adoption of smoking cessation treatments for PWH. METHODS: We compared the feasibility and acceptability (primary outcomes) and preliminary efficacy (secondary outcome) of a DTx tailored to PWH — Learn to Quit-HIV (LTQ-H) — versus a gold standard smoking cessation DTx (QuitGuide) in a remote pilot randomized controlled trial. All participants received nicotine replacement therapy and were assessed at weeks 4, 8, and 12. RESULTS: During a 13-month period, we remotely recruited a sample of PWH (n = 41) across the United States, with randomization leading to a higher proportion of LTQ-H users with high levels of cannabis use. Digital markers of DTx use indicated that compared to QuitGuide, assignment to LTQ-H led to significantly greater number of device interactions (3610 vs 2086; RR=93.14; 95 % CI: 14.70-590; p < 0.001), and a four-fold increase in mean interactions with active smoking cessation content (8.5 vs. 2.15; Cohen's d=0.91; p < 0.001). At week 12, in an adjusted model, LTQ-H resulted in numerically greater, but not statistically significant, biochemically verified 7-day point prevalence abstinence versus QuitGuide (18.2 % vs 15.8 %; aOR=6.97, 95 % CI: 0.65-74.33). CONCLUSIONS: While participants assigned to LTQ-H had proportionally more features known to predict low quit rates (e.g. cannabis use), LTQ-H showed promising population reach, device engagement, and smoking outcomes. A hybrid effectiveness-implementation trial will evaluate this novel DTx in a larger sample of PWH. IMPLICATIONS: The study highlights the potential of DTx to address the high prevalence of tobacco use among people with HIV. Compared to QuitGuide (gold standard DTx d
💨 While this study examines digital therapeutics for tobacco cessation rather than cannabis use, the findings offer relevant insights for cannabis-prescribing clinicians managing PWH, a population with elevated rates of both tobacco and cannabis use. The study’s focus on digital intervention delivery and acceptability in a traditionally underserved population demonstrates how technology can bridge engagement gaps, though we should note that cannabis use disorder comorbidity, drug-drug interactions with antiretroviral therapy, and the distinction between tobacco and cannabis cessation mechanisms are not addressed in this abstract. The feasibility data may inform how we structure patient education and monitoring for PWH using cannabis medicine, particularly regarding shared decision-making platforms and remote follow-up. Clinically, this suggests that digitally-enabled cessation support could complement traditional office-based counseling for our PWH patients managing multiple substance use patterns, though we’ll need cannabis-specific outcome data before drawing direct parallels to our prescribing practices.