title: Smoking cessation and recidivism in the Women's Interagency Human Immunodeficiency Virus Study.
abstract: BACKGROUND
  Smoking increases the risk of morbidity and mortality and is particularly harmful to HIV-infected people.
  
  
  OBJECTIVE
  To explore smoking trends and longitudinal factors associated with smoking cessation and recidivism among participants in the Women's Interagency HIV Study.
  
  
  METHODS
  From 1994 through 2011, a total of 2,961 HIV-infected and 981 HIV-uninfected women were enrolled and underwent semi-annual interviews and specimen collection. Smoking prevalence was evaluated annually and risk factors associated with time to smoking cessation and recidivism were analyzed in 2013 using survival models.
  
  
  RESULTS
  The annual cigarette smoking prevalence declined from 57% in 1995 to 39% in 2011 (p-trend<0.0001). Among smokers, factors significantly associated with a longer time to smoking cessation included less education, alcohol use, having health insurance, >10-year smoking duration, self-reported poor health rating, and having hypertension. Pregnancy in the past 6 months was associated with a shorter time to cessation. Among HIV-infected women, additional risk factors for longer time to cessation included lower household income, use of crack/cocaine/heroin, CD4 cell count ≤200, and highly active antiretroviral therapy (HAART) use. Predictors of smoking recidivism included marijuana use, enrollment in 1994-1996, and not living in one's own place. Among HIV-infected women, enrollment in 2001-2002 and crack/cocaine/heroin use were associated with a shorter time to recidivism, whereas older age and HAART use were associated with a longer time to recidivism.
  
  
  CONCLUSIONS
  Despite declining rates of cigarette smoking, integrated interventions are needed to help women with and at risk for HIV infection to quit smoking and sustain cessation.
authors.affiliation: Department of Clinical Pharmacy , University of California, San Francisco. Electronic address: Nancy.Hessol@ucsf.edu.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Hessol
authors.affiliation: CORE Center, Cook County Health and Hospital System and Rush University, Chicago, Illinois.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Weber
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Gypsyamber
authors.initials: G
authors.lastname: D'Souza
authors.affiliation: Department of Community Health Sciences, School of Public Health, State University of New York Downstate Medical Center, Brooklyn.
authors.forename: Dee
authors.initials: D
authors.lastname: Burton
authors.affiliation: Georgetown University School of Medicine, Washington DC.
authors.forename: Mary
authors.initials: M
authors.lastname: Young
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Joel
authors.initials: J
authors.lastname: Milam
authors.affiliation: Division of Internal Medicine , Montefiore Medical Center, Bronx, New York.
authors.forename: Lynn
authors.initials: L
authors.lastname: Murchison
authors.affiliation: Department of Medicine, University of California, San Francisco.
authors.forename: Monica
authors.initials: M
authors.lastname: Gandhi
authors.affiliation: CORE Center, Cook County Health and Hospital System and Rush University, Chicago, Illinois; Department of Medicine, Cook County Health and Hospital System and Rush University, Chicago, Illinois.
authors.forename: Mardge H
authors.initials: MH
authors.lastname: Cohen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D000074606:Smoking Prevention; D013997:Time Factors; D055815:Young Adult
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