Factors Associated with Tobacco Smoking and Cessation among HIV-Infected Individuals under Care in Rio de Janeiro, Brazil

Abstract

Worldwide the prevalence of smoking among people living with HIV/AIDS is elevated compared to the general population. This probably reflects the cluster of individual characteristics that have shared risk factors for HIV infection and smoking. A cross-sectional study, enrolling a convenience sample from a Brazilian HIV clinical cohort was conducted to evaluate the prevalence of tobacco smoking and the factors associated with current smoking and abstinence. A total of 2,775 HIV-infected individuals were interviewed: 46.2% have never smoked, 29.9% were current smokers and 23.9% were former smokers. Current smokers had a higher prevalence of alcohol and illicit drug use when compared to the other two groups. A higher proportion of heterosexual individuals were former smokers or never smokers while among men who have sex with men (MSM) a higher proportion were current smokers. Former smokers had been more frequently diagnosed with high blood pressure, diabetes mellitus, cardiovascular diseases and depression, while for current smokers lung diseases were more frequent. Former smokers and current smokers were more likely to have had any hospital admission (42.0% and 41.2%, respectively) than participants who never smoked (33.5%) (p<0.001). Multivariate model results showed that current smokers (versus never smokers) were more likely to be less educated, to report the use of alcohol, crack and cocaine and to present clinical comorbidities. Former smokers (versus current smokers) were more likely to be older, to have smoked for a shorter amount of time and to have smoked >31 cigarettes/day. MSM (compared to heterosexuals) and cocaine users (versus non-users) had lower odds of being former smokers. Considering our results, smoking cessation interventions should be tailored to younger individuals, MSM and substance users.

HIV Infection Is Not Associated with Carotid Intima-Media Thickness in Brazil: A Cross-Sectional Analysis from the INI/ELSA-Brasil Study

“…As the disease approaches the status of a manageable chronic condition, other risk factors, such as eating habits physical activity, alcohol use, treatment of hypertension, diabetes, socio-demographic characteristics and the effects of aging start to play a more important role for the health status in this population. In addition, chronic exposure to medication [ 7 – 11 ], higher prevalence of smoking [ 12 ], metabolic syndrome [ 13 ] and HCV-coinfection [ 14 ] are other important factors that could be linked to increased risk of CVD in this population.…”

Self-rated health and substance use among individuals in HIV care in Rio de Janeiro, Brazil: a cross-sectional study

“…To account for a large number of participants with missing CD4 + T lymphocyte counts (n = 442) and HIV-1 RNA levels (n = 429), a sensitivity analysis was conducted using the aforementioned statistical methods for participants with both CD4 + T lymphocyte counts and HIV-1 RNA levels (n = 576). Guided by previous findings, 33 colinearity between 90-day crack/cocaine use and 90-day tobacco use was tested. When it was found, tobacco was excluded from regression models.…”

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

“…Studies of urban GBMSM have also found smoking rates to be higher and cessation rates lower in HIV-positive men (Robinson et al, 2014). People living with HIV/AIDS (PLWHA) who smoke are at elevated risk for several comorbid conditions including pulmonary infectious diseases, cancer, cardiovascular disease, and tuberculosis (Helleberg et al, 2015; Torres et al, 2014). Further, PLWHA who smoke report lower treatment adherence, higher viral load counts, and are less likely to attend routine medical visits (O’Cleirigh et al, 2015b).…”

“…However, the majority of this research has been cross-sectional (e.g., Gamarel et al, 2015; Lifson et al, 2010; Levinson et al, 2012; Newcomb et al, 2014; O’Cleirigh et al, 2015a; Robinson et al, 2014; Torres et al, 2014; Tron et al, 2013) and almost none have adopted a longitudinal design. Cross-sectional studies in the United States found that 45–72% of GBMSM report attempted cessation in the previous year, and preparation to quit was associated with daily (vs. non-daily) smoking, having a smoke-free home, asking a doctor for advice, and having used nicotine replacement therapy (Levinson et al, 2012; Robinson et al, 2014).…”