title: Poly-tobacco use among HIV-positive smokers: implications for smoking cessation efforts.
abstract: BACKGROUND
  Poly-tobacco use is defined as cigarette and other tobacco consumption with either product used daily or nondaily. While concurrent use of different types of tobacco has been documented within the general population, less is known about poly-tobacco use among HIV-positive smokers and its impact on smoking cessation efforts.
  
  
  OBJECTIVE
  To characterize the profile of poly-tobacco users (PTU) in a sample of HIV-positive smokers participating in a cessation program.
  
  
  METHODS
  The study sample consisted of 474 HIV-positive smokers enrolled in a 2-group randomized controlled trial of cigarette smoking cessation comparing a cell phone-based intervention to usual care. Prevalence was determined, and risk factors for poly-tobacco use were evaluated using logistic regression.
  
  
  RESULTS
  In this cohort of HIV-positive cigarette smokers, 21.6% of participants were PTU, with cigars (73.4%) the most common tobacco product consumed. Among PTU, 73.5% used other form(s) of tobacco some days, and 26.5% use them every day. Perceived discrimination and unemployment were significantly associated with poly-tobacco use after adjusting for other demographic, behavioral, and psychosocial factors. Analysis showed that participants in the cell phone group (vs. usual care) were more likely to report 24-hr abstinence, both among monocigarette users (16.6% vs. 6.3%, p < .001) and PTU (18.5% vs. 0%, p < .001).
  
  
  CONCLUSIONS
  Poly-tobacco use prevalence among adult HIV-positive smokers was considerably higher than in the general population. Special attention must be placed on concurrent use of cigarettes and cigars among HIV-positive smokers. Because PTU are a unique population less likely to succeed in brief smoking cessation interventions, effective cessation programs are needed.
authors.affiliation: Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX;
authors.forename: Irene
authors.initials: I
authors.lastname: Tamí-Maury
authors.forename: Damon J
authors.initials: DJ
authors.lastname: Vidrine
authors.forename: Faith E
authors.initials: FE
authors.lastname: Fletcher
authors.forename: Heather
authors.initials: H
authors.lastname: Danysh
authors.forename: Roberto
authors.initials: R
authors.lastname: Arduino
authors.forename: Ellen R
authors.initials: ER
authors.lastname: Gritz
mesh_terms: D000328:Adult; D040421:Cell Phone; D015331:Cohort Studies; D003710:Demography; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D013781:Texas / Q000453:epidemiology; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000517:prevention & control; D016896:Treatment Outcome
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