IntroductionPeople living with HIV (PLWH) are more likely to smoke than the general population and are at greater risk of smoking-related illness. Healthcare services need to address this burden of preventable disease.MethodsWe evaluated the impact of a brief intervention that asked service users about smoking when they attended for ambulatory HIV care in London, UK, and offered referral to smoking cessation.ResultsOverall, 1548 HIV-positive individuals were asked about their smoking status over a 12-month period. Of this group, 385 (25%) reported that they were current smokers, 372 (97%) were offered referral to smoking cessation services and 154 (40%) accepted this. We established an outcome of referral for 114 (74%) individuals. A total of 36 (10% of smokers) attended stop smoking clinics and 16 (4%) individuals were recorded as having quit smoking.DiscussionThe simple intervention of asking PLWH about tobacco smoking and offering referral to smoking cessation services rapidly identified current smokers, 40% of whom accepted referral to smoking cessation services. This highlights the importance of promoting behaviour and lifestyle changes with every contact with health services. However, a large proportion of those referred were either not seen in local services or the outcome of referral could not be ascertained. If the risk of smoking-related morbidity among PLWH is to be reduced, more sustainable referral pathways and ways of improving uptake of smoking cessation services must be developed.

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BackgroundHIV infected individuals are at increased risk of smoking-related illness and smoking rates amongst populations with HIV are often significantly higher than the general population. Interventions that reduce the prevalence of smoking in this population are urgently required.AimsWe sought to establish the impact of initiating regular smoking screening and advice by healthcare assistants (HCAs) or nurses as part of routine care appointments in a HIV ambulatory care service.MethodsIndividuals attending for ambulatory HIV care appointments were asked brief screening questions regarding cigarette smoking by Healthcare Assistants (HCAs) or nurses. This was completed whilst clinical observations were performed, allowing this intervention to be delivered as part of routine care. Those who were current smokers were given Very Brief Advice (VBA) regarding smoking cessation and offered referral to smoking cessation services. The number of referrals to smoking cessation services was compared to the six months prior to the introduction of the enhanced service.Results1,031 individuals were screened between October 2014 and March 2015: 262 (25%) reported that they were current smokers. 248 (93%) of these smokers were provided with VBA and the opportunity of referral to smoking cessation services. Of these, 103 (38%) accepted referral compared to 6 referrals from the HIV outpatient service in the preceding 6 months.ConclusionsAn intervention to ask service users about smoking and provide smoking cessation advice can be undertaken as part of routine care in an ambulatory HIV care service and is effective in identifying smokers and increasing referrals to smoking cessation services. Further work will evaluate the impact of this intervention in HIV positive subjects.