Observational studyPsychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors2025
The role of alternative reinforcers in smoking outcomes among people with and without HIV.
Observational study in Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivePeople with HIV (PWH) smoke at higher rates than people without HIV (PWOH). Alternative reinforcers, or behaviors that replace (substitute reinforcers) or maintain (complementary reinforcers) smoking, are associated with smoking outcomes but have not been studied among PWH. This observational study assessed whether alternative reinforcers changed during a quit attempt among PWH and PWOH and whether the associations differed between groups.
methodThe parent study included 274 participants (93 PWH and 181 PWOH) who sought treatment for smoking cessation in a 12-week program. The present analyses were limited to 173 (73 PWH and 100 PWOH) study completers. The primary outcomes were changes in substitute and complementary reinforcers at the end of treatment (EOT; week 12) measured using the Pleasant Events Schedule. We performed linear regressions in the overall sample and then stratified by HIV status for each alternative reinforcer. The time (baseline; week 0 vs. EOT) by smoking status at EOT (abstinent vs. nonabstinent) interaction was tested.
resultsSelf-reported substitute reinforcers increased significantly over time, but this was not associated with smoking or HIV status (
conclusionsDeclines in complementary reinforcers were associated with smoking cessation outcomes among PWH. These findings partially support results from prior literature, suggesting that addressing complementary reinforcers during smoking cessation treatment may be crucial in improving quit rates among PWH. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
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