1. Tobacco Use in the MMC ID Clinic Population: Clinical and Research Activities AECOM/MMC Tobacco Think Tank September 8, 2009

3. Cigarette smoking is epidemic among PLWHAs in the USA. 60% of the MMC ID Clinic patients are active cigarette smokers. State and national statistics are describing significant increases in incidences of cardiac events, COPD/emphysema, lung, and oropharyngeal cancer in this population.

4. American Legacy Foundation 2006-7 Shuter, Moadel, Bernstein Study of the biobehavioral bases of smoking and quitting in a random sample of PLWHA smokers and ex-smokers 60 smokers and 30 ex-smokers completed in- depth, one-on-one structured interviews A smoking cessation brochure was developed in response to the information gathered

9. American Legacy Foundation 2007-2008 Shuter, Moadel, Bernstein Used data collected in Year 1 to develop the Positively Smoke Free intensive cessation program curriculum, and piloted it in six groups of PLWHA smokers Matching funds: Latino Commission on AIDS (NYSDOH), Bronx BREATHES (Bernstein)

10. American Legacy Foundation 2008-2009 Shuter, Strecher (U. Michigan) Developed Positively Smoke Free on the Web, the first and only web-based cessation program that targets smokers living with HIV/AIDS www.positivelysmokefree.com

12. American Legacy Foundation 2009-2010 Shuter, Strecher (U. Michigan) Develop a Spanish version of Positively Smoke Free on the Web Incorporate a library of provider resources on the website Matching funds AECOM Cancer Prevention and Control Research Program (Rapkin)

13. RCT of Positively Smoke Free on-site Intensive Intervention R21 NIDA (Shuter, Moadel, Bernstein, Arnsten) Will create a revised version of the curriculum that incorporates buddy support into the treatment model RCT of intensive intervention vs. standard of care (85 per study condition) Primary outcome=3 month abstinence

14. Motivating Latinos to Quit Smoking R01 NIDA (Niaura/Stanton PIs [Brown University], Shuter, Moadel co-Inv.) RCT of one-on-one culturally tailored counseling sessions versus standard of care Projected MMC enrollment=100 Primary endpoint=12 month abstinence

15. Translational Research Exhaled DNA methylation in HIV-infected vs. uninfected individuals CFAR-AECC pilot grant (Spivack, Shuter) Plan to enroll 100 PLWHA subjects (smokers, ex-smokers, never smokers) 17 enrolled to date

16. Tobacco Use and Antiretroviral Adherence

17. Provider Attitudes and Beliefs about Tobacco Use Unfunded study: Shuter, Moadel Survey of the HIVMA on-line provider registry 363 completed surveys (75%) from providers caring for 75,000 PLWHAs in 46 states Analysis is ongoing

18. Pending Application R01 (Shuter, Stanton, Moadel, Strecher, Niaura): RCT of a tailored web-based smoking cessation vs. standard care for PLWHA smokers