E-cigarette Harm Reduction Among PLWHA in South Africa

The purpose of this pilot randomized controlled trial study aims to address the unmet need for feasible and efficacious strategies for reducing combustible cigarette (CC) use among people living with HIV/AIDS (PLWHA) in South Africa, which has the potential to significantly improve the health and long-term survival of PLWHA CC smokers. Using the proposed intervention, based on the Information-Motivation-Behavioral Skills (IMB), and a simultaneous embedded mixed methods approach, the investigators will evaluate a telehealth program targeting CC harm reduction, comparing E-cigarettes (EC) to nicotine replacement therapy (NRT) that is enhanced by integrating ecological momentary intervention (EMI) texting. As such, this proposal will significantly build research capacity in South Africa to conduct telehealth tobacco treatment interventions using innovative EMI approaches enhancing participants' engagement, as well as state-of-the art evaluation approaches.

Inclusion Criteria: * Adult PLWHA CC smokers; * Speaks Afrikaans, or Xhosa, or English; * reports daily CC smoking (≥ 5 CPD); * Owns any type of mobile phone; * interested in reducing CC smoking but not necessarily trying to quit; * Receives HIV/AIDS care in one of the eight selected clinics follow-up rates. Exclusion Criteria: * are pregnant or breastfeeding; * unable to provide consent; * used tobacco products other than CC in the past 2 weeks (e.g., EC, cigarillo); * currently engaged in an attempt to quit CC smoking; * current major depressive or manic episode, current psychotic disorder, past-year suicide attempt, or current suicidal ideation with plan or intent. plan or intent.