{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:28:15Z","timestamp":1760059695106,"version":"build-2065373602"},"reference-count":53,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute on Drug Abuse of the National Institutes of Health","award":["R01DA030276"],"award-info":[{"award-number":["R01DA030276"]}]},{"name":"College Research Council of the College of Veterinary Medicine and Biomedical Sciences at Colorado State University.","award":["R01DA030276"],"award-info":[{"award-number":["R01DA030276"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The nicotine metabolite ratio (NMR) has been informative in selecting treatment choices for nicotine dependence and increasing treatment efficacy in Western settings; however, the clinical utility of the NMR among smokers in low-resource settings remains unclear. Prospective analysis was conducted using data from a randomized controlled trial of smoking cessation among adults living with HIV, to examine the association between the NMR and response to smoking cessation treatment. NMR was assessed using bio-banked urine samples collected at baseline. Self-reported smoking at 6 months was verified using a urine cotinine test and exhaled breath carbon monoxide (CO). We found no associations between the NMR and smoking abstinence (adjusted risk ratio (aRR) = 0.82; 95% CI: 0.45, 1.49; p = 0.53). No evidence of effect modification by treatment conditions was observed on the multiplicative scale (aRR = 1.17; 95% CI: 0.32, 4.30; p = 0.81) or additive scale (adjusted relative excess risk due to interaction (aRERI) = 0.10; 95% CI: \u22121.16, 1.36; p = 0.44). Our results suggest that the NMR may not be a viable approach for selecting smoking cessation treatment in this setting, given the minimal variability in our sample and racial\/ethnic makeup of this population.<\/jats:p>","DOI":"10.3390\/ijerph22071040","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T06:18:36Z","timestamp":1751264316000},"page":"1040","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Nicotine Metabolite Ratio and Response to Smoking Cessation Treatment Among People Living with HIV Who Smoke in South Africa"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7224-6248","authenticated-orcid":false,"given":"Chukwudi","family":"Keke","sequence":"first","affiliation":[{"name":"Department of Environmental and Radiological Health Science, Colorado State University, Fort Collins, CO 80523, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6825-0573","authenticated-orcid":false,"given":"Limakatso","family":"Lebina","sequence":"additional","affiliation":[{"name":"Africa Health Research Institute, Somkhele, Myeki 3935, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7644-1038","authenticated-orcid":false,"given":"Katlego","family":"Motlhaoleng","sequence":"additional","affiliation":[{"name":"Perinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg 2193, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0856-3540","authenticated-orcid":false,"given":"Raymond","family":"Niaura","sequence":"additional","affiliation":[{"name":"School of Global Public Health, New York University, New York, NY 10003, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Abrams","sequence":"additional","affiliation":[{"name":"School of Global Public Health, New York University, New York, NY 10003, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ebrahim","family":"Variava","sequence":"additional","affiliation":[{"name":"Klerksdorp Tshepong Hospital Complex, Matlosana 2574, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikhil","family":"Gupte","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan E.","family":"Golub","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil A.","family":"Martinson","sequence":"additional","affiliation":[{"name":"Perinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg 2193, South Africa"},{"name":"Johns Hopkins University Center for TB Research, Baltimore, MD 21231, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4298-6395","authenticated-orcid":false,"given":"Jessica L.","family":"Elf","sequence":"additional","affiliation":[{"name":"Department of Environmental and Radiological Health Science, Colorado State University, Fort Collins, CO 80523, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,30]]},"reference":[{"key":"ref_1","unstructured":"UNAIDS (2024, December 14). 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