No differences in delay discounting between smokers with and without HIV
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ORIGINAL INVESTIGATION
No differences in delay discounting between smokers with and without HIV Cory Czuczman 1 & Morgan Thompson 1 & E. Paul Wileyto 2,3 & Robert Schnoll 1,4 & David Metzger 1 & Frank Leone 5 & Karam Mounzer 6 & Robert Gross 2,3 & Rebecca L. Ashare 1 Received: 8 April 2020 / Accepted: 30 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Rationale People with HIV (PWH) smoke cigarettes at much higher rates than the general population and evidence-based cessation methods are less effective, putting PWH at greater risk for negative health outcomes. It is critical to identify the factors that underlie this health disparity. Delay discounting—the decline in the value of a reward when it is delayed—may explain this disparity. Objectives This study aimed to (1) compare delay discounting between adult smokers with HIV and without HIV and (2) evaluate whether acute smoking abstinence disproportionately increases delay discounting among smokers with HIV. Methods This sub-study was part of a larger study (NCT03169101) examining predictors of smoking cessation outcomes among smokers with HIV (n = 34) and smokers without HIV (n = 46) at two counterbalanced laboratory sessions (once smoking-asusual and once following 24-h biochemically confirmed abstinence) then again, after 8 weeks of smoking cessation treatment. Results There were no significant differences in delay discounting rates between HIV status groups (p = 0.49) or within-subject abstinence effects (p = 0.70). However, smokers without HIV exhibited a significant increase in delay discounting following smoking cessation treatment compared to baseline (p = 0.02), whereas the change among smokers with HIV did not reach statistical significance (p = 0.09). Conclusions These findings do not support differences in delay discounting as a reason for the lower success rates of HIV+ smokers at quitting. Although delay discounting may not explain the disparity in smoking rates between people with and without HIV, future work should focus on additional correlates of higher smoking rates and lower quit rates among people with HIV. Keywords Smoking . Abstinence . Decision-making . Delay discounting . HIV . Tobacco cessation
Background
* Rebecca L. Ashare [email protected] 1
Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite, Philadelphia, PA 4100, USA
2
Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
3
Department Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, USA
4
Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
5
Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA, USA
6
Philadelphia FIGHT, 1233 Locust St., Philadelphia, PA, USA
Cigarette smokers are at risk for a myriad of health conditions including hypertension, cancer, and heart disease, which can reduce quality of life and shorten life spa
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