title: Motivation to quit smoking among HIV-positive smokers in Vietnam.
abstract: BACKGROUND
  Smoking cessation is emerging as an important component in current HIV care to reduce smoking-related adverse health outcomes. This study aimed to examine motivation to quit and its associated factors in a sample of 409 HIV-positive smokers in Vietnam.
  
  
  METHODS
  A cross-sectional survey was conducted from January to September 2013 in Hanoi (the capital) and Nam Dinh (a rural city). Motivation to quit was measured by a 4-point single item, and was dichotomized as having any motivation versus no motivation. Smoking history, nicotine dependence (Fagerstrom Test of Nicotine Dependence), and other covariates were self-reported by participants. Multivariate logistic regression was performed to identify correlates of motivation to quit.
  
  
  RESULTS
  The sample was mostly male (97%). Mean age was 36 years (SD = 5.8). Approximately 37% and 69% of the sample were hazardous drinkers and ever drug users, respectively. The mean duration of HIV infection and ART treatment were 6 years (SD = 3.6) and 5 years (SD = 2.2), respectively. Overall, 59% of the sample was motivated to quit. Factors significantly associated with motivation to quit were income, pain, currently taking Methadone, and the interaction between binge drinking and lifetime drug use. Individuals with the highest income level (OR = 2.2, 95% CI = 1.3-3.6), moderate income level (OR = 1.8, 95% CI = 1.1-3.1), and currently feeling pain (OR = 1.6, 95% CI = 1.0-2.5) were more likely to be motivated to quit. Conversely, taking Methadone was associated with a lower likelihood of motivation to quit (OR = 0.4, 95% CI = 0.2-0.9). Also, those who reported binge drinking only (OR = 0.5, 95% CI = 0.3-0.9), lifetime drug use only (OR = 0.3, 95% CI = 0.1, 0.7), or both substance uses (OR = 0.4, 95% CI = 0.2, 0.8) were less motivated to quit smoking.
  
  
  CONCLUSIONS
  Smoking cessation treatment should be integrated into HIV care in Vietnam, and should be tailored to meet specific needs for individuals with different attitudes on smoking, low income, and polysubstance use.
authors.affiliation: Department of Pharmacoeconomics & Pharmacoepidemiology, Hanoi University of Pharmacy, 13-15 Le Thanh Tong St, Hanoi, Vietnam. nhungnguyen.hup@gmail.com.
authors.forename: Nhung Thi Phuong
authors.initials: NT
authors.lastname: Nguyen
authors.affiliation: Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam. bach@hmu.edu.vn.|Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. bach@hmu.edu.vn.
authors.forename: Bach Xuan
authors.initials: BX
authors.lastname: Tran
authors.affiliation: The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA. Lu-Yu.Hwang@uth.tmc.edu.
authors.forename: Lu Y
authors.initials: LY
authors.lastname: Hwang
authors.affiliation: The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA. Christine.Markham@uth.tmc.edu.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Markham
authors.affiliation: The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA. Michael.D.Swartz@uth.tmc.edu.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Swartz
authors.affiliation: Department of Health Disparities Research, Division of OVP, Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. JIrvinVidrine@mdanderson.org.
authors.forename: Jennifer I
authors.initials: JI
authors.lastname: Vidrine
authors.affiliation: Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam. huongphanmoh@gmail.com.
authors.forename: Huong Thu Thi
authors.initials: HT
authors.lastname: Phan
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. clatkin@jhu.edu.
authors.forename: Carl A
authors.initials: CA
authors.lastname: Latkin
authors.affiliation: Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Unit 1330, Houston, TX, 77030, USA. dvidrine@mdanderson.org.
authors.forename: Damon J
authors.initials: DJ
authors.lastname: Vidrine
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006679:HIV Seropositivity; D006801:Humans; D008297:Male; D009042:Motivation; D011203:Poverty; D016540:Smoking Cessation / Q000523:psychology* / Q000706:statistics & numerical data; D014744:Vietnam