CIGARETTE SMOKING BEHAVIORS AMONG PEOPLE LIVING WITH HIV: ASSOCIATIONS WITH INDIVIDUAL- AND SOCIAL-LEVEL CHARACTERISTICS
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Date
2013-09-20
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Johns Hopkins University
Abstract
INTRODUCTION: Smoking is endemic among people with HIV and associated with morbidity and mortality. Little research has been conducted among smokers with HIV. Research has focused on examining individual-level characteristics associated with smoking behaviors, with little examination of social-level factors. Aim 1 included a literature review concerning the intersection of HIV and smoking. Aims 2-4 explored individual- and social-level characteristics associated with current smoking (Aim 2), interest in quitting or cutting down (Aim 3), and lifetime quit attempts (Aim 4).
METHODS: Data for Aims 2-4 came from a study designed to examine social environmental influences on HIV-positive current/former drug users’ health outcomes in Baltimore, Maryland. Logistic regression (Aims 2 and 4) and multinomial logistic regression (Aim 3) analyses were used to explore associations between covariates and outcomes.
RESULTS:
Aim 1: Literature concerning smoking among HIV-positive populations was reviewed. Topics included: morbidity, mortality, treatment and medication adherence outcomes; characteristics associated with smoking behaviors; evidence-based cessation interventions; findings from cessation interventions among smokers with HIV. Gaps in the literature and directions for future research were identified.
Aim 2: Most participants (75%) were smokers. Drug use (aOR=2.82, 95% CI=1.55-5.13), 12-step program participation (aOR=1.74, 95% CI=1.02-2.96), and having a main Supporter who smokes (aOR=2.01, 95% CI=1.14-3.54) were associated with current smoking.
Aim 3: Individuals who made lifetime quit attempts were more likely than those who had not to be interested in quitting (aRRR=3.50, 95% CI=1.39-8.30). Family encouragement to smoke was negatively associated with interest in cutting down (aRRR=0.09, 95% CI=0.01-0.86) and interest in quitting (aRRR=0.27, 95% CI=0.08-0.90).
Aim 4: Older age (45-49: aOR=3.44, 95% CI=1.60-7.39; 54-65: aOR=2.74, 95% CI=1.22-6.17), non-Black race (aOR=3.61, 95% CI=1.23-10.62), and having a main Supporter who had used NRT or medications for cessation (aOR=2.40, 95% CI=1.24-4.63) were positively associated with an increased likelihood of lifetime use of NRT or medications for smoking cessation.
CONCLUSIONS: Results corroborate research indicating that smoking is a significant public health problem among people with HIV. Results extend knowledge by suggesting that social- and individual-level characteristics are associated with smoking behaviors among people with HIV. Results have implications for cessation interventions among smokers with HIV.
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Keywords
cigarette smoking, HIV, substance use, social environment