Trends and Correlates of Cigarette Smoking and Its Impacts on Health-Related Quality of Life Among People Living with HIV: Findings from the Ontario HIV Treatment Network Cohort Study, 2008-2014.
We sought to examine the trends of cigarette smoking, identify correlates of smoking, and examine the impacts of smoking on health-related quality of life (HRQOL) among people living with HIV in Ontario, Canada. Study sample included 4473 individuals receiving care and enrolled in the Ontario HIV Treatment Network Cohort Study. Self-report data on cigarette smoking, HRQOL, and demographic and sociobehavioral variables were collected between 2008 and 2014 through annual face-to-face interviews. Clinical data were abstracted from participants' medical records and enhanced through linkage with a provincial public health laboratory database. Analyses included descriptive statistics, generalized logit regression, and linear mixed-effects modeling. At first interview, 1760 participants (39.3%) were current cigarette smokers. Smoking prevalence declined annually by 1.6% between 2008 and 2014, but remained much higher than the prevalence in the general population. Current cigarette smokers were more likely to be younger, male, white or indigenous, Canadian-born, single, unemployed with lower education, heavy drinkers, nonmedicinal drug users, and to have current depression than former cigarette smokers or those who never smoked. Current cigarette smokers also had significantly (p < 0.001) worse SF-12 physical component summary (β = -2.07) and SF-12 mental component summary (β = -1.08) scores than those who never smoked after adjusting for demographic, socioeconomic, and HIV-related clinical variables. To reduce the burden of cigarette smoking, cessation interventions that take into account the complex social, economic, and medical needs of people living with HIV are needed urgently.
1 The Ontario HIV Treatment Network , Toronto, Canada .
Tsegaye
T
Bekele
2 Institute for Mental Health Policy Research , Centre for Addiction and Mental Health, Toronto, Canada .|3 Department of Psychiatry, University of Toronto , Toronto, Canada .|4 Institute of Health Policy, Management and Evaluation, University of Toronto , Toronto, Canada .
Sergio
S
Rueda
5 Baycrest Health Sciences , Toronto, Canada .|6 Dalla Lana School of Public Health, University of Toronto , Toronto, Canada .
Sandra
S
Gardner
6 Dalla Lana School of Public Health, University of Toronto , Toronto, Canada .|7 Toronto General Research Institute, University Health Network , Toronto, Canada .
Janet
J
Raboud
8 Department of Pathology and Molecular Medicine, McMaster University , Hamilton, Canada .|9 St. Joseph's Health Care , Hamilton, Canada .
Marek
M
Smieja
10 The AIDS Network , Hamilton, Canada .
Richard
R
Kennedy
11 Maple Leaf Medical Clinic , Toronto, Canada .
David
D
Fletcher
6 Dalla Lana School of Public Health, University of Toronto , Toronto, Canada .|12 Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute , St. Michael's Hospital, Toronto, Canada .|13 Department of Family and Community Medicine, St. Michael's Hospital , Toronto, Canada .
Ann N
AN
Burchell
1 The Ontario HIV Treatment Network , Toronto, Canada .
Jean
J
Bacon
1 The Ontario HIV Treatment Network , Toronto, Canada .|3 Department of Psychiatry, University of Toronto , Toronto, Canada .|12 Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute , St. Michael's Hospital, Toronto, Canada .
Sean B
SB
Rourke
D000328:Adult; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D006304:Health Status; D006801:Humans; D008297:Male; D009864:Ontario / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology* / Q000639:trends; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors
correlates of smoking; health-related quality of life; people living with HIV; trend of cigarette smoking