Changes in smoking status among a longitudinal cohort of gay, bisexual, and other men who have sex with men in Vancouver, Canada

Abstract

Background Cigarette smoking is common among gay, bisexual, and other men who have sex with men (GBMSM) and most of the mortality gap between HIV-positive and HIV-negative individuals is attributable to smoking. Methods We recruited sexually active HIV-positive and HIV-negative GBMSM age ≥16 years using respondent-driven sampling. Study visits occurred every six months for up to four years and included a computer-assisted self-interview and clinical assessment. We conducted bivariate analyses to compare factors associated with “never”, “former”, “daily”, or “non-daily” smoking at baseline and longitudinal mixed effects models to examine factors associated with cessation and (re)initiation. Results 774 participants completed a baseline visit and 525 enrolled in the cohort and completed at least one follow-up visit. At baseline, the median age was 34 years and 31.5% were daily smokers. In follow-up (median=2.5 years), 116 daily or non-daily smokers (41%) quit at least once and of these, 101 (87%) remained former smokers at their last visit. Smoking cessation was positively associated with incomes ≥$60,000 and self-reported excellent health. Alcohol use, ecstasy use, and having a partner who smokes were associated with decreased odds of cessation. Substance use (cannabis, GHB, and crystal methamphetamine) and having a partner who smokes were positively associated with increasing to/resuming daily smoking. HIV-positive GBMSM were more likely to smoke but not more likely to quit. Conclusions Targeted, culturally relevant smoking cessation resources are needed, especially for HIV-positive GBMSM. Engaging couples in cessation interventions may be useful.

Worldwide relative smoking prevalence among people living with and without HIV

“…Gerend et al (2017) included cisgender men and transgender women [60] . Shariati et al (2017) included all participants who identified as male including cisgender men and transgender men [68] .…”

“…There were insufficient data on the sexual orientation and smoking status of individual participants to permit a sensitivity analysis across all studies. We were able to conduct a posthoc subgroup analysis of four studies whose participants comprised only MSM in both HIV seropositive and HIV seronegative groups [55,60,68,80] . We found that MSM who were also PLH had significantly higher odds of smoking than HIV seronegative MSM: OR 1.67 (95% CI 1.04-2.68) (supplementary figure 5).…”

“…All male ---Restricted to 24 [67] Americas (Brazil) [53] European (France) [76] Africa (Uganda) 47% 48% Mean = 35 Mean = 35 Cross sectional PLH and HIV seronegative: drawn from a community cohort study in which PLH were age and sex matched to adults in the same district None identified [68] Americas (Canada) All identified as male…”

Demographic, Behavioral, and Social Characteristics Associated With Smoking and Vaping Among Men Who Have Sex With Men in San Francisco

“…Cohen’s d was also calculated for bivariable analyses effect sizes. Variables chosen were either factors previously reported to be associated with smoking or hypothesized potential predictors of smoking (Agaku et al, 2014; Akhtar-Khaleel et al, 2016; Shariati et al., 2017). The multivariable analyses used a model-building algorithm suggested by Hosmer and Lemeshow in which predictors in the bivariate analyses with a p value <.25 were included in the multivariable analysis and used a stepwise backward elimination approach to fit the most parsimonious model (Bursac, Gauss, Williams, & Hosmer, 2008; Hosmer & Lemeshow, 2000).…”

Using Social Networks to Supplement RDD Telephone Surveys to Oversample Hard-to-Reach Populations: A New RDD+RDS Approach

“…The number of targets in each network is adjusted for network size, to reduce the impact of large networks (Filteau, Agans, and Zeng 2017). RDS has been used to survey many hard-to-survey populations, including lesbian, gay, bisexual, and transgender (LGBT) individuals and tobacco users (Arfken, Abu-Ras, and Ahmed 2015; Baggett et al 2016; Jarvis et al 2008; Lippert 2017; Mason et al 2015; Sadasivam et al 2013; Shariati et al 2017; Stubera, Galea, and Link 2008); it is suitable for our research endeavor, but with some important modifications.…”