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 living with HIV, making scalable cessation tools a meaningful clinical priority.
#23 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 represent a scalable intervention to address smoking cessation in people living with HIV, a population with disproportionately high tobacco prevalence and smoking-related morbidity. This pilot trial provides evidence on whether DTx can achieve adequate reach, feasibility, and acceptability in PWH, addressing a significant gap in accessible smoking cessation treatments for a medically vulnerable population. Demonstrating preliminary efficacy alongside feasibility metrics establishes the clinical and logistical foundation for larger implementation studies in HIV care settings.
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 pilot study addresses an important gap in smoking cessation support for people living with HIV, the incomplete abstract limits our ability to fully evaluate the intervention’s design, outcomes, and relevance to cannabis medicine practice. Digital therapeutics show promise for improving reach and engagement in underserved populations, though we should note that tobacco use patterns in PWH often overlap with cannabis use, and cessation interventions may need adapted messaging if cannabis is part of a patient’s harm reduction or symptom management strategy. The feasibility and acceptability data will be valuable for understanding implementation barriers, but pilot trials typically have small sample sizes and may not capture real-world adherence or long-term quit rates across diverse HIV populations. As clinicians, we should recognize that while digital tools can extend our reach, they work best when integrated into comprehensive care that addresses the social determinants and concurrent substance use patterns common in this population. If your PWH patients are using cannabis as part of their nicotine cessation efforts or stress management, consider discussing this openly and ensuring your smoking cess