Living with HIV, antiretroviral treatment experience and tobacco smoking: results from a multisite cross-sectional study.
BACKGROUND
To assess the prevalence of and factors associated with tobacco smoking and dependence in HIV patients.


METHODS
In a one-day cross-sectional national survey of a representative sample of 82 French units specialized in HIV-infected patient care, 727 consecutive outpatients were asked to complete a self-administered questionnaire, assessing smoking habits, dependence, cessation motivation, other substance abuse, sociocultural characteristics, life with HIV and its treatment. Smoking prevalence and dependence were assessed and compared with a representative sample of the general French population.


RESULTS
The questionnaire was completed by 593 (82%) patients: 12% were active or ex-intravenous drug users, 37% were homosexual men, and 43% were active smokers (compared with 31% in the French population) of whom 56% were classified as moderately or highly dependent. Fourteen percent of smokers were highly motivated and free of other substance abuse and of depressive symptoms. Smoking was independently associated with male sex (odds ratio [OR] = 2.38; 95% confidence interval [CI] 0.99-1.11), lower body mass index (OR 1.08; 95% Cl 1.14-1.03), smoking environment (OR 4.75; 95% Cl 3.02-7.49), excessive alcohol consumption (OR 2.50; 95% CI 1.20-5.23), illicit drug use (OR 2.43; 95% CI 1.41-4.19), HIV status disclosure to family (OR 1.81; 95% CI 1.16-2.85) and experience of rejection due to disclosure (OR 1.90; 95% CI 1.14-3.17). Disclosure and drug substitute usage were associated with high tobacco dependence.


CONCLUSIONS
Very few HIV smokers seem to be good candidates for a standard tobacco cessation program. Tobacco reduction or cessation strategies should be adapted to this population.
Inserm, Clinical Investigation Center 007, Inserm 738, Bichat, Paris, France xavier.duval@bch.aphp.fr
Xavier
X
Duval
Gabriel
G
Baron
Daniel
D
Garelik
Virginie
V
Villes
Thierry
T
Dupré
Catherine
C
Leport
France
F
Lert
Patrick
P
Peretti-Watel
Philippe
P
Ravaud
Bruno
B
Spire
D000223:Adaptation, Psychological; D000328:Adult; D017954:Africa South of the Sahara; D000352:Africa, Northern; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D016017:Odds Ratio; D011287:Prejudice; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D016540:Smoking Cessation / Q000523:psychology; D000074606:Smoking Prevention; D019966:Substance-Related Disorders / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D014342:Truth Disclosure
D044966:Anti-Retroviral Agents