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.
    Addictive behaviors 05/2013; 38(10):2541-2546. DOI:10.1016/j.addbeh.2013.05.003 · 2.44 Impact Factor
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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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    ABSTRACT: Tobacco addiction and chronic pain represent 2 highly prevalent and comorbid conditions that engender substantial burdens upon individuals and systems. Interrelations between pain and smoking have been of clinical and empirical interest for decades, and research in this area has increased dramatically over the past 5 years. We conceptualize the interaction of pain and smoking as a prototypical example of the biopsychosocial model. Accordingly, we extrapolated from behavioral, cognitive, affective, biomedical, and social perspectives to propose causal mechanisms that may contribute to the observed comorbidity between these 2 conditions. The extant literature was 1st dichotomized into investigations of either effects of smoking on pain or effects of pain on smoking. We then integrated these findings to present a reciprocal model of pain and smoking that is hypothesized to interact in the manner of a positive feedback loop, resulting in greater pain and increased smoking. Finally, we proposed directions for future research and discussed clinical implications for smokers with comorbid pain disorders. We observed modest evidence that smoking may be a risk factor in the multifactorial etiology of some chronically painful conditions and that pain may come to serve as a potent motivator of smoking. We also found that whereas animal studies yielded consistent support for direct pain-inhibitory effects of nicotine and tobacco, results from human studies were much less consistent. Future research in the emerging area of pain and smoking has the potential to inform theoretical and clinical applications with respect to tobacco smoking, chronic pain, and their comorbid presentation. (PsycINFO Database Record (c) 2011 APA, all rights reserved).
    Psychological Bulletin 10/2011; 137(6):1065-93. DOI:10.1037/a0025544 · 14.39 Impact Factor
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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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    ABSTRACT: Most HIV-positive persons in the U.S. smoke cigarettes. Despite substantial clinical advances in HIV care in the era of highly active antiretroviral therapy (HAART), HIV-positive persons are at high risk of tobacco-related disease and death. HIV-positive persons have complex social, economic, psychiatric, and medical needs that may impact smoking behavior and response to smoking cessation interventions, but there is a dearth of research on smoking cessation interventions tailored to HIV-positive persons. HIV care providers should treat tobacco use with the array of evidence-based smoking cessation treatments available, updating their clinical practice as new data emerge. This article reviews the literature on the health consequences of tobacco use in HIV-positive persons, the treatment of tobacco dependence, and the research to date on smoking cessation interventions in HIV-positive persons, and it presents recommendations for future research and intervention.
    AIDS education and prevention: official publication of the International Society for AIDS Education 07/2009; 21(3 Suppl):14-27. DOI:10.1521/aeap.2009.21.3_supp.14 · 1.51 Impact Factor
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