Contemplation of Smoking Cessation and Quit Attempts in HIV-Infected and Uninfected Veterans (original) (raw)

Substance Abuse, 2015

Abstract

As antiretroviral treatments prolong life in HIV-infected patients, smoking cessation is now a top priority. However, studies of HIV-infected smokers have not been conducted with uninfected controls. We determined factors associated with contemplating smoking cessation and making a prior quit attempt among HIV-infected and uninfected smoking Veterans. Between 2005 and 2007, we identified 1027 HIV-infected and 794 uninfected smokers enrolled in the Veterans Aging Cohort Study (VACS). Stratifying by HIV status, we calculated adjusted odd ratios using logistic regression to identify factors associated with contemplating smoking cessation and making a prior quit attempt. Most participants (66% of HIV-infected vs. 68% of uninfected, p=0.46) were contemplating cessation, and 56% of both groups (p=0.99) had attempted to quit in the last year. In stratified multivariable analyses, HIV-infected smokers with recent pulmonary disease diagnoses were more likely to have made a quit attempt (AOR 4.93, 95% CI=1.41-17.17). Both HIV-infected and uninfected patients with unhealthy alcohol use were less likely to be contemplating cessation (AOR 0.66, 95% CI=0.49-0.90 and 0.71, 95% CI=0.50-1.00). HIV-infected smokers who reported unhealthy alcohol use were also less likely to have made a quit attempt in the last year (AOR 0.68, 95% CI=0.51-0.91). Patient-level interest and motivation are not major barriers to smoking cessation among HIV-infected Veterans. Targeting HIV-infected smokers with a recent pulmonary disease diagnosis may improve sustained smoking cessation. Unhealthy alcohol use appears to be a key modifiable risk factor. Smoking cessation rates may be improved by combining interventions for smoking and alcohol use for HIV-infected patients.

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