title: Tobacco use among adults initiating treatment for HIV infection in rural Uganda.
abstract: We conducted a longitudinal study of tobacco use among adults initiating antiretroviral therapy (ART) in Mbarara, Uganda where 11 % of men and 3 % of women use tobacco according to the 2011 Demographic and Health Survey. In a prospective cohort, self-reported tobacco use was assessed before starting ART and reassessed every 3-4 months. Plasma cotinine, a nicotine metabolite, was measured in a subset of adults pre-ART to verify self-report. Among 496 subjects, 50 (10 %) reported current tobacco use (20 % of men, 6 % of women). Most (53 %) adults with elevated cotinine levels (>15 ng/mL) reported no tobacco use. By 6 months after ART initiation, 33 % of tobacco users had quit (95 % CI 20-46 %). By 5 years, 64 % quit (95 % CI 47-77 %). Self-reported tobacco use among rural Ugandans starting ART was twice as common as among the local background population and use may be underreported. ART initiation could be an opportunity for tobacco cessation interventions.
authors.affiliation: Division of General Medicine, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, 9th Floor, Boston, MA, 02114, USA, gkruse@partners.org.
authors.forename: Gina R
authors.initials: GR
authors.lastname: Kruse
authors.forename: David R
authors.initials: DR
authors.lastname: Bangsberg
authors.forename: Judith A
authors.initials: JA
authors.lastname: Hahn
authors.forename: Jessica E
authors.initials: JE
authors.lastname: Haberer
authors.forename: Peter W
authors.initials: PW
authors.lastname: Hunt
authors.forename: Conrad
authors.initials: C
authors.lastname: Muzoora
authors.forename: John P
authors.initials: JP
authors.lastname: Bennett
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Martin
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Rigotti
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012424:Rural Population / Q000706:statistics & numerical data*; D012923:Social Class; D064424:Tobacco Use / Q000453:epidemiology* / Q000517:prevention & control; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000517:prevention & control; D014454:Uganda / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents