Researchers from Vanderbilt University Medical Center joined colleagues from Pavlov First State Medical University and other partner institutions to explore how different smoking cessation aids impact alcohol use among people living with HIV. The study found that three distinct cessation strategies helped reduce alcohol consumption three months after treatment began and was published in JAMA Network Open.
The analysis drew on data gathered by clinicians at Pavlov First State Medical University named after II. Pavlov. A total of 400 volunteers living with HIV in Russia were enrolled to examine patterns of heavy drinking and tobacco use. Eligibility criteria included men consuming five or more drinks on a typical occasion or women consuming four or more drinks on a typical occasion for at least five days in the last month, along with smoking five or more cigarettes each day. The goal was to understand how integrated approaches to addiction treatment might affect substance use outcomes in a population often underrepresented in clinical trials.
Participants were assigned to one of three active treatment arms corresponding to the cessation aids under investigation: nicotine replacement therapy, varenicline, or cytisine. A placebo group was included to ensure rigorous evaluation, and both participants and researchers were blinded to which medication was administered within each arm. The trial followed participants for 12 months from enrollment, providing a window into medium term effects on drinking and smoking behaviors as well as potential health implications associated with reduced use of both substances.
By the three month mark, reductions in both alcohol and cigarette consumption were observed across all treatment arms. Importantly, abstinence from alcohol tended to be higher among those who continued smoking cessation efforts, suggesting a possible synergy between quitting tobacco and lowering alcohol intake in this population. These findings contribute to a broader discussion about how combined strategies can influence substance use trajectories in people living with HIV, a group at elevated risk for hepatitis, mental health challenges, and multiple substance use disorders.
Experts note that excessive alcohol use and tobacco dependence frequently co-occur and compound health risks, including cardiovascular disease and certain cancers. The study emphasizes that addressing both issues simultaneously may be critical for improving overall health outcomes in people living with HIV. The authors also caution that additional research is needed to determine whether the observed effects are primarily driven by the pharmacological actions of the cessation aids, by behavioral changes linked to quitting smoking, or by a combination of both factors. The study underlines the value of including diverse populations in addiction research to better inform prevention and treatment strategies in North America and beyond.
Contributors to the research include investigators from Vanderbilt University Medical Center, Boston University School of Medicine, Boston Medical Center, Pavlov First State Medical University, Bekhterev National Center for Psychiatry and Neurology Medical Research, and the National Institutes of Health in Bethesda, Maryland. The collaborative effort demonstrates how cross-border partnerships can enhance our understanding of addiction management in populations facing concurrent health challenges and access barriers. The findings offer a foundation for future trials that might disentangle the individual and combined effects of smoking cessation medications and nicotine withdrawal on alcohol use, while informing clinical guidelines and patient-centered care in Canada, the United States, and similar settings where HIV prevalence intersects with substance use concerns. The broader takeaway is that integrated, patient-focused approaches hold promise for reducing the burden of tobacco and alcohol use among people living with HIV, ultimately contributing to longer, healthier lives.