Tobacco use and nicotine dependence among people living with HIV who drink heavily in South Africa: a cross-sectional baseline study

Abstract

Background: People living with HIV (PLWH) who drink alcohol and use tobacco are particularly vulnerable to tobacco-induced diseases due to an already compromised immune system. This study investigated the prevalence and factors associated with tobacco use (cigarette and snuff) among PLWH who drink heavily. Methods: Participants (n = 623) on antiretroviral therapy for HIV who reported heavy drinking using the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-C were recruited from six hospitals in Gauteng Province, South Africa. The Fagerström test was used to assess nicotine dependence. Chi Square tests and modified Poisson regression analyses were conducted to identify factors associated with tobacco use. Results: Almost half of the participants reported ever smoking (44.0%; CI: 40.1-47.9) and about a quarter reported ever using snuff (25.5%; CI: 22.2-29.1). Current smokers and current snuff users comprised 27.3% (CI: 23.9-30.9) and 19.1% (CI: 16.2-22.3) of all participants respectively. Among current smokers, 37.9% (CI: 30.8-45.3) were moderately/ highly dependent on nicotine. Current 'any tobacco product users' (ATPU: use cigarettes or snuff) were 45.4% (CI: 41.5-49.3) while 1.0% (CI: 0.4-2.0) currently used cigarettes and snuff. Adjusted regression analyses showed that, compared to males, females were less at risk of being: ever smokers (Relative Risk Ratio [RRR] = 0.33;

Tobacco Smoking and Associated Factors Among People Living With HIV in Uganda

“…Whilst other studies in Sub-Saharan Africa have reported moderate to high levels of nicotine dependence among PLWH who smoke, 57 for our study, the levels of nicotine dependence were low to moderate among current smokers. Motivation and willingness to quit smoking were also high in our study population.…”

Tobacco Use among HIV-Positive and HIV-Negative Women and Men in Zambia—Demographic and Health Survey, 2018

“…We identified several sociodemographic characteristics that were associated with tobacco use among women and tobacco smoking among men, including age, residence (urban/rural), education level, employment status, and wealth index. Our findings were consistent with previous studies which also demonstrated that those in older age groups [ 25 , 26 , 27 ], with lower levels of education [ 3 , 25 , 28 , 29 , 30 , 31 , 32 ], employment such as household service, manual, or agricultural work [ 3 , 30 , 31 ], or lower wealth [ 3 , 32 ] were more likely to use tobacco. Perhaps paradoxically, we found that tobacco use was more prevalent among residents of rural areas; however, once we controlled for other sociodemographic characteristics in logistic regression models, residents of urban areas were more likely to use or smoke tobacco.…”

“…Second, data gleaned from DHS were cross-sectional in nature and, therefore, causality could not be determined. Third, data were not available for several factors, which may be related to either HIV or tobacco use, including ART [ 28 ], mental health [ 5 , 22 , 25 , 32 ], and substance use [ 5 , 22 , 28 , 30 , 32 ]; thus, we were unable to account for these factors. Additional health indicators, such as domestic violence or maternal health, may also be associated with HIV or tobacco use; the inclusion of these indicators was beyond the scope of the current study but may warrant future exploration.…”

Clinical Audit on Symptomatology of Covid-19 Healthcare Workers and Impact on Quality-of-Life (QOL) Due to Continuous Facemask Usage: A Prospective Study

“…Cattaruzza et al [ 36 ] had observed a positive relation between smokers and severe Covid-19 (OR = 2.25) and that smokers had a relatively bad prognosis if they developed Covid-19 lung symptoms. However, a direct influence on the disease nature due to alcohol consumption was elaborated in studies by Testino et al [ 37 ], Ruuskanen et al [ 38 ] and Egbe et al [ 39 ]. This line of study was beyond the scope of this article.…”