People living with human immunodeficiency virus (HIV) have a higher prevalence of smoking and are less likely to quit smoking than the general population. Few studies involving a large sample of people living with HIV (PLWH) receiving routine care have evaluated factors associated with smoking cessation. A team of researchers including Drs. Cosmas Zyambo, alumni, Craig Wilson, and Peter Hendricks from the University of Alabama at Birmingham School of Public Health, collaborated with others on this study.

This retrospective longitudinal cohort study evaluated factors associated with smoking cessation among PLWH from 2007 to 2018. Of 1,714 PLWH smokers included in the study, 27.6 percent reported quitting smoking. Suppressed plasma HIV-1 RNA (lesss than 200 copies/ml) was significantly associated with an increased likelihood of smoking cessation (HRadjusted = 1.27, 95 percent CI [1.03, 1.58]); whereas age/10 year increments (HRadjusted = 0.12, 95 percent CI [0.04, 0.38]), greater length of care at the HIV clinic (HRadjusted = 0.97, 95 percent CI [0.94, 0.99]), lack of insurance (HRadjusted = 0.77, 95 percent CI [0.61, 0.99]) or having public insurance (HRadjusted = 0.74, 95 percent CI [0.55, 0.97)]), current substance use (HRadjusted = 0.66, 95 percent CI [0.43, 0.97]) and risk of developing alcohol use disorder (HRadjusted = 0.60, 95 percent CI [0.43, 0.84]) were associated with a reduced likelihood of quitting smoking.

These findings underscore the importance of early smoking cessation intervention among PLWH. In addition, targeted smoking cessation intervention strategies are needed for groups at risk for being less likely to quit, including older patients, and those with alcohol and substance use disorders.