title: Non-cigarette tobacco and poly-tobacco use among persons living with HIV drawn from a nationally representative sample.
abstract: BACKGROUND
  Smoking is more prevalent among persons living with HIV (PLWH) than the general population. Little is known about the prevalence of non-cigarette tobacco and poly-tobacco use (PTU; using multiple tobacco products) among this population, which, in the general population is associated with poor health and cessation outcomes. We aimed to characterize the prevalence of cigarette and non-cigarette tobacco use, PTU, and correlates of tobacco use status among a nationally-representative sample of PLWH.
  
  
  METHODS
  Data came from 472 HIV-positive adults from the 2005-2013 National Survey on Drug Use and Health (NSDUH).
  
  
  RESULTS
  The prevalence of PTU overall was 8.7% (95% CI=5.6-13.2), and 16.6% (95% CI=10.2-25.7) among past-year tobacco users. In multinomial logistic regression analyses, participants with a high school education or greater (aRRR=2.03, 95% CI=1.03-4.00) were more likely to be non-tobacco users than single product users. Past year drug users (aRRR=0.35, 95% CI=0.19-0.66) and past month binge drinkers (aRRR=0.24, 95% CI=0.12-0.50) were less likely to be non-tobacco users than single product users. Compared to 18-25 year olds, individuals age 26-34 (aRRR=0.13, 95% CI=0.03-0.65) and 35+ (aRRR=0.24, 95% CI=0.09-0.63), and with lifetime anxiety disorder(s) (aRRR=0.18, 95% CI=0.06-0.57) were less likely to be PTUs as compared to single product users. Individuals who reported liking to test themselves by doing risky things were more likely to be PTUs than single product users (aRRR=2.95, 95% CI=1.27-6.84).
  
  
  CONCLUSIONS
  PTU was slightly higher than in the general population, and should be taken into account when developing cessation interventions tailored to tobacco users living with HIV.
authors.affiliation: Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States. Electronic address: lauren.pacek@duke.edu.
authors.forename: Lauren R
authors.initials: LR
authors.lastname: Pacek
authors.affiliation: Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States.
authors.forename: Maggie M
authors.initials: MM
authors.lastname: Sweitzer
authors.affiliation: Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States.
authors.forename: F Joseph
authors.initials: FJ
authors.lastname: McClernon
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D062789:Tobacco Products / Q000706:statistics & numerical data*; D064424:Tobacco Use / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Comorbidity; HIV; Poly-tobacco use; Smoking; Tobacco; Vulnerable populations