Article

Adverse Impact of Cigarette Smoking on Dimensions of Health-Related Quality of Life in Persons with HIV Infection

Division of Pulmonary & Critical Care Medicine, San Francisco General Hospital, 1001 Potero Avenue, Room 5K1, San Francisco, CA 94110, USA.
AIDS PATIENT CARE and STDs (Impact Factor: 3.58). 12/2001; 15(12):615-24. DOI: 10.1089/108729101753354617
Source: PubMed

ABSTRACT Because effects of cigarette smoking on health-related quality of life (HRQL) have not been well described, we carried out a cross-sectional assessment of HRQL using the Medical Outcomes Survey Scale adapted for patients with human immunodeficiency virus (MOS-HIV questionnaire) in 585 HIV-infected homosexual/bisexual men, injection drug users, and female partners enrolled in a multicenter, prospective study of the pulmonary complications of HIV infection. Mean scores for the following dimensions of HRQL were calculated: general health perception, quality of life, physical functioning, bodily pain, social functioning, role functioning, energy, cognitive functioning, and depression. A multivariate model was used to determine the impact on HRQL of the following factors: smoking, CD4 loss, acquired immune deficiency syndrome (AIDS) diagnoses, number of symptoms, study site, education, injection drug use, gender, and age. Current smoking was independently associated with lower scores for general health perception, physical functioning, bodily pain, energy, role functioning, and cognitive functioning (all with p < 0.05). We conclude that patients with HIV infection who smoke have poorer HRQL than nonsmokers. These results support the use of smoking cessation strategies for HIV-infected persons who smoke cigarettes.

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    • "; Pines, Koutsky, & Buskin, 2011; Rahmanian et al., 2011). Similarly, continued smoking among PLHIV has been linked to lower quality of life (Crothers et al., 2005; Ingersoll, Cropsey, & Heckman, 2009), increased pain (Turner et al., 2001), and diminished cognitive functioning (Turner et al., 2001). Moreover, both uncontrolled HIV infection and antiretroviral therapy may confer an elevated risk for cardiovascular disease that is further exacerbated by cigarette use (Elzi et al., 2006; Lifson et al., 2010). "
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    ABSTRACT: PLHIV have higher rates of smoking and lower motivation to quit smoking; thus to impact smoking rates, cessation interventions need to be acceptable to a wider range of PLHIV smokers as well as feasible to implement in a busy clinical setting. The purpose of this study was to evaluate the acceptability, feasibility, and effects of a Screening, Brief Intervention, and Referral for Treatment (SBIRT) model in an HIV/AIDS clinic among a sample of PLHIV. PLHIV smokers (N=40) were randomized at baseline, irrespective of their self-reported discrete smoking cessation motivation status, to receive either 8-weeks of combination nicotine replacement therapy (NRT) in conjunction with brief counseling (SBIRT framework) (n=23) or usual care (n=17). Smoking outcome measures included cigarettes smoked per day, nicotine dependence, smoking urge, and smoking withdrawal symptoms. The SBIRT intervention appeared to be acceptable and feasible, and produced medium to large reductions in cigarettes smoked per day, physical nicotine dependence, smoking urge, and smoking withdrawal symptoms, even for smokers not ready to quit within 6months. Findings provide preliminary support for the integration of an SBIRT model in an HIV/AIDS clinic setting to screen and provide active treatment to all smokers, regardless of readiness to quit smoking. Given the high prevalence and incredible health burden of continued smoking in this population, identifying brief and effective interventions that are easily translated into clinical practice represents an enormous challenge that if met, will yield significant improvements to overall patient outcomes.
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    • "Smoking—In addition to those reviewed herein, there is evidence of associations between tobacco smoking and the prevalence/ severity of several other painful conditions, including: fibromyalgia (Lee et al., 2010; Weingarten, Podduturu, et al., 2009; Wolfe & Hawley, 1998; Yunus, Arslan, & Aldag, 2002), dyspepsia (Wildner-Christensen, Hansen, & De Muckadell, 2006), menstrual pain (Allen, Hatsukami, Christianson, & Brown, 2000; Gold et al., 2007), pregnancy-related pelvic pain (Biering, Aagaard Nohr, Olsen, Nybo Andersen, & Juhl, 2010), Buerger's disease (Quintas & Albuquerque, 2008), HIV-related bodily pain (Patel et al., 2006; Turner et al., 2001), painful temporomandibular joint disorders (Melis et al., 2010; Weingarten, Iverson, et al., 2009), and pain associated with osteoarthritis (Amin et al., 2007) and sickle cell disease (Cohen, DeBaun, Blinder, Strunk, & Field, 2010). "
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    • "Among HIV-positive individuals, current cigarette smoking was independently related to a decrease in general health perception, physical functioning, energy, role functioning, and cognitive functioning and an increase in physical pain, adjusting for age, immunologic function and other covariates (J. Turner et al., 2001). Another study found that HIV-positive current smokers experience greater physical symptoms and decreased quality of life compared to former and never smokers (Crothers et al., 2005). "
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