Tobacco use and readiness to quit smoking in low‐income HIV‐infected persons

Abstract

The study aim was to identify covariates of smoking status and readiness to quit that encompassed key sociodemographic and health status variables, health-related quality of life, drug use and unprotected sex, and tobacco use variables in a cohort of low-income persons living with HIV. We also examined the impact of HIV diagnosis on smoking cessation. The sample (N = 428) was mostly male (59%) and Black (53%) or Hispanic (30%), and had a high school education or less (87%). Mean age was 40 years. Two-thirds of participants were current smokers, 19% former smokers, and 16% never smokers. Current smokers smoked a mean of 16 cigarettes/day for 22 years; 42% were in the precontemplation stage of readiness to quit smoking, 40% were contemplators, and 18% were in preparation. Most current smokers (81%) reported receiving medical advice to quit smoking. Multivariate logistic regression analyses indicated that current smokers, compared with former smokers, were more likely to use illicit drugs, perceive a lower health risk for continued smoking, and report less pain. Current smokers, compared with nonsmokers (former and never smokers), were more likely to report greater illicit drug use in their lifetime, current illicit drug use, and less pain. A multiple linear regression indicated that greater current illicit drug use, greater emotional distress, and a lower number of quit attempts were associated with lower stage of readiness to quit smoking. These findings confirm a high prevalence of smoking among HIV-infected persons and suggest a complex interplay among drug use, pain, and emotional distress that impact smoking status and, among smokers, readiness to quit. Tobacco control programs for HIV-infected persons should build motivation to quit smoking and address salient barriers to cessation--such as comorbid drug use, emotional distress, pain, and access to and coverage for treatment--and should educate smokers regarding the HIV-specific health benefits of cessation.

HIV Infection in the Etiology of Lung Cancer: Confounding, Causality, and Consequences

“…Compared with the 20% prevalence of smoking in the United States general population (1), the prevalence of smoking has consistently been reported as higher in HIV-infected populations (Table 1) (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). In numerous studies of smoking prevalence conducted in varied risk groups from the United States and Europe, more than two thirds of HIV-infected persons have reported being a regular smoker at some time in their life.…”

“…Clinics and cohorts with large representation of injection drug users (IDUs) have often been observed to have the highest smoking prevalence, with almost uniform smoking exposure (14). Several other studies that characterized their HIV-infected population as ''lower income'' have had estimates of 63 to 86% for ever smoking and 47 to 67% range for current smoking prevalence (6,9,12). Among studies largely comprised of men who have sex with men, the prevalence of ever smoking was similar, although current smoking ranged from 31 to 54% (2, 5, 7)…”

Smoking Cessation for People Living With HIV/AIDS: A Literature Review and Synthesis

“…1 By contrast, between 50% and 70% of PLWHA smoke cigarettes daily. 3,5,[10][11][12][13] On a positive note, one longitudinal study showed that smoking rates may be declining among women with HIV (to 39% in 2011 in the Women's Interagency HIV Study). 14 Although the reasons for this high prevalence are not well understood, there are some factors that appear to distinguish nonsmoking from smoking PLWHA.…”

Hydroxychloroquine and smoking in patients with cutaneous lupus erythematosus

“…58,59 Similarly, cigarette smoking is harmful to health, yet 50-70% of HIV-positive people smoke despite their compromised immune systems. [60][61][62][63] There are no data on smoking and use of sunscreens or sun-protective clothing.…”