Prevalence of cigarette smoking and associated factors in a large sample of HIV-positive patients receiving antiretroviral therapy in Vietnam.
BACKGROUND
Cigarette smoking presents a salient risk for HIV-positive populations. This study is among the first to examine smoking prevalence, nicotine dependence, and associated factors in a large sample of HIV-positive patients receiving antiretroviral therapy (ART) in Vietnam.


METHODS
A cross-sectional study of 1133 HIV-positive people was conducted from January to September 2013 at 8 ART clinics in Hanoi (the capital) and Nam Dinh (a rural area). Smoking history and nicotine dependence (Fagerstrom Test of Nicotine Dependence-FTND) were assessed by participant self-report. Logistic regression and Tobit linear regression were performed to identify factors significantly associated with smoking outcomes.


RESULTS
Prevalence of current, former, and never smokers in the sample was 36.1%, 9.5%, and 54.4%, respectively. The current smoking proportion was higher in males (59.7%) than females (2.6%). The mean FTND score was 3.6 (SD = 2.1). Males were more likely to currently smoke than females (OR = 23.4, 95% CI = 11.6-47.3). Individuals with problem drinking (OR = 1.8, 95% CI = 1.1-2.9) and ever drug use (OR = 3.7, 95%CI = 2.5-5.7) were more likely to be current smokers. Older age and currently feeling pain were associated with lower nicotine dependence. Conversely, receiving care in Nam Dinh, greater alcohol consumption, ever drug use, and a longer smoking duration were associated with greater nicotine dependence.


CONCLUSIONS
Given the high prevalence of smoking among HIV-positive patients, smoking screening and cessation support should be offered at ART clinics in Vietnam. Risk factors (i.e., substance use) linked with smoking behavior should be considered in prevention programs.
The University of Texas Health Science Center at Houston, Houston, TX 77030, United States of America; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Unit 1330, Houston, TX 77030, United States of America; Hanoi University of Pharmacy, Hanoi, Vietnam.
Nhung Phuong Thi
NP
Nguyen
Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
Bach Xuan
BX
Tran
The University of Texas Health Science Center at Houston, Houston, TX 77030, United States of America.
Lu Y
LY
Hwang
The University of Texas Health Science Center at Houston, Houston, TX 77030, United States of America.
Christine M
CM
Markham
The University of Texas Health Science Center at Houston, Houston, TX 77030, United States of America.
Michael D
MD
Swartz
Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam.
Huong Thu Thi
HT
Phan
Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
Vuong Minh
VM
Nong
Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
Cuong Tat
CT
Nguyen
Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
Anh Hue
AH
Nguyen
Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
Carl A
CA
Latkin
Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Unit 1330, Houston, TX 77030, United States of America.
Damon J
DJ
Vidrine
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D008297:Male; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology*; D012959:Socioeconomic Factors; D014744:Vietnam
D019380:Anti-HIV Agents