Smoking Cessation for Persons Living With HIV: A Review of Currently Available Interventions

ArticleinThe Journal of the Association of Nurses in AIDS Care: JANAC 21(1):3-10 · October 2009with3 Reads
DOI: 10.1016/j.jana.2009.03.007 · Source: PubMed
Abstract
Smoking among persons living with HIV infection (PLWH) is estimated to be two to three times greater than the general population. Data suggest that cigarette smoking is more common among PLWH because of factors such as lower socioeconomic status, previous or concurrent illicit drug and alcohol use, age, education level, and concurrent depressive symptoms. Cigarette smoking in HIV-infected individuals has been associated with higher risk of certain cancers, infections, and a decrease in response to antiretroviral therapy. Recent guidelines from the U.S. Public Health Service have recommended the use of counseling and pharmacologic therapies for all patients interested in quitting smoking. It is critical for clinicians caring for PLWH to be familiar with these modalities. This article provides an overview of currently available interventions for smoking cessation, reviews considerations for patients with HIV, and discusses clinical implications for nurses and advanced practice clinicians.
    • "Although the prevalence of smoking in the general population has decreased from 42 % in 1965 to 18 % in 2012 [1], a high prevalence of smoking persists among people living with HIV (PLWH). Studies have reported smoking prevalence estimates for PLWH that are approximately two to three times greater than those for the general population, ranging from 40.5 to 74 % [2][3][4][5][6][7]. In the era of widely available and effective antiretroviral therapy (ART), the life expectancy of HIV-infected individuals can approach that of individuals who are uninfected [8, 9]. "
    [Show abstract] [Hide abstract] ABSTRACT: Tobacco smoking is associated with adverse health effects among people living with HIV (PLWH), including a higher risk of cancer and cardiovascular problems. Further, there is evidence that PLWH are two to three times more likely to smoke than the general population. The aim of this study was to examine the association between tobacco smoking and biomarkers of HIV disease progression, including unsuppressed viral load (viral load >200 copies/mL) and low CD4 cell count (<200 cells/mm3). Recent tobacco smoking was reported by 40 % (n = 5942) of 14,713 PLWH enrolled in Ryan White Part A programs in the New York City metropolitan area. In multivariate analyses controlling for sociodemographic and clinical characteristics, recent tobacco smoking was independently associated with unsuppressed viral load (AOR = 1.38, CI 1.26–1.50) and low CD4 cell count (AOR = 1.12, CI 1.01–1.24). Findings suggest the importance of routine assessments of tobacco use in clinical care settings for PLWH.
    Full-text · Article · Feb 2016
    • "disease progression. In general, anxiety and depression are known to be related with cigarette smoking or alcohol drinking (Boschloo et al., 2013; Khaled, Bulloch, Exner, & Patten, 2009; Kimbrel, Morissette, Gulliver, Langdon, & Zvolensky, 2014) and cigarette smoking is more common among HIV-infected individuals because of depressive symptoms (Jeffrey & Kathryn, 2010). As a result of it, quality of life can be adversely affected (Lim & Kim, 2013) and the duration of survival will be decreased (Ickovics et al., 2001). "
    [Show abstract] [Hide abstract] ABSTRACT: Patients infected with human immunodeficiency virus (HIV) may develop mental health problems such as anxiety and depression, which negatively impact of disease progression. We investigated factors associated with the prevalence of anxiety and depression symptoms among HIV-infected patients in Korea. A total of 840 HIV-infected patients who participated in the Korea HIV/AIDS Cohort Study from 2006 to 2012 were evaluated. Socio-demographic, epidemiologic, and clinical variables were obtained through standardized questionnaires. The State-Trait Anxiety Inventory and Beck Depression Inventory were used to assess the symptoms of anxiety and depression. Multiple logistic regression analyses were performed to identify factors associated with symptoms of anxiety and depression. The prevalence of anxiety and depressive symptoms among HIV-infected patients was 32% and 36%, respectively. Ex-smoker and persistent symptoms for more than one week within the past six months and diagnosis of HIV infection within one year were associated with increased anxiety symptoms (odds ratio [OR] 1.71, 95% confidence interval [CI] 1.09-2.69; OR 1.52, 95% CI 1.09-2.11; OR 1.49, 95% CI 1.02-2.20) and current smoking and persistent symptoms were also associated with increased depressive symptoms (OR 2.10, 95% CI 1.31-3.30; OR 1.87, 95% CI 1.25-2.79). Marital status, current smoking, current drinking, and persistent symptoms were associated with both increased anxiety and depressive symptoms (OR 1.75, 95% CI 1.07-2.88; OR 1.66, 95% CI 1.06-2.61; OR 1.88, 95% CI 1.18-2.99). The prevalence of anxiety and depressive symptoms among HIV-infected patients is higher than those estimated for the general population. This study shows the necessity to evaluate symptoms of anxiety and depression and suggest psychological support for HIV-infected patients who smoke or have persistent symptoms or have sexual partner or drink.
    Full-text · Article · Jul 2015
    • "The findings are consistent with those of other studies on smoking prevalence among PLWH. PLWH who smoke have a substantially increased risk of cardiovascular disease; AIDS-defining conditions, including candidiasis, bacterial pneumonia, cervical cancer, and anal cancer; lung cancer; and liver cancer (Helleberg et al., 2013; Kwong & Bouchard-Miller, 2010; Lifson 2010). Smoking causes a systemic inflammation and decreases immune function, which contributes to the increased risk of diseases and certain types of cancers (Helleberg et al., 2013) . "
    [Show abstract] [Hide abstract] ABSTRACT: Background: Since the advent of highly active antiretroviral therapy in the mid-nineties, deaths among persons living with HIV (PLWH) have declined nationally. Now a controllable condition, HIV has become a chronic disease, highlighting the importance of tobacco cessation in lowering morbidity and premature mortality. Current smoking is approximately twice as high among PLWH compared with the general population. PLWH who smoke experience higher rates of cardiovascular disease, AIDS-defining illnesses, and cancer than PLWH who do not smoke. Loss of life-years associated with smoking among PLWH is greater than life-years lost from HIV. Methods: Data on current smoking, derived from the 2009-12 Georgia Medical Monitoring Project (MMP) were analyzed. Smoking rates were calculated by demographic characteristics, and results were compared to those from the 2011 Georgia Behavioral Risk Factor Surveillance System (BRFSS), a population-based telephone survey. Results: The prevalence of current smoking among PLWH was 36.1%, compared with 21.2% among the general population in Georgia. Smoking prevalence for PLWH generally varied by demographic characteristics according to the same pattern as for the general population, but prevalence was consistently higher among PLWH. Conclusions: The prevalence of current smoking among PLWH in Georgia is high. Clinical and public health interventions must address smoking cessation as part of HIV care to prevent disease, improve quality of life, and reduce mortality. HIV- infected smokers have more barriers to quitting (alcohol, depression, drug dependence, and inaccurate risk perception) and a lower quit rate than non-HIV-infected smokers. Efficacy studies of behavioral and pharmacological interventions for smoking cessation specific to PLWH are needed.
    Full-text · Article · Jul 2015 · AIDS Care
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