Attitudes to smoking and quitting in UK HIV positive adults: Would more education help?

Abstract

Background: HIV infection is associated with increased risk of smoking-related illness, yet people living with HIV (PLWH) are more likely to smoke than the general population in the UK. Aims: To explore attitudes towards smoking and readiness to quit in adult PLWH compared to HIV negative individuals. Methods: Cross-sectional observational study: PLWH were recruited from a metropolitan HIV care service; HIV negative participants were recruited from Sexual Health clinics. Participants completed a questionnaire including details of tobacco smoking, attitudes towards smoking cessation and beliefs regarding HIV-related respiratory illness. Results: 402 individuals were invited, of whom 197 PLWH and 93 HIV negative participants of similar demographic and socioeconomic backgrounds agreed. 30% and 33% respectively were current smokers and 28% vs 25% ex-smokers (p=0.94). 65% of PLWH and 59% of HIV negative smokers either intended to, or wished to, stop smoking (p=0.56). When asked to rate the importance of stopping smoking on a 1-10 scale, there was no significant difference in mean scores between HIV positive and negative participants. Only 33% of PLWH agreed with the statement that there is an increased risk of developing lung cancer and 21% agreed that HIV is associated with the early onset of smoking-related lung disease. Conclusions: Our data suggest that PLWH should be priority group for smoking cessation services and HIV status does not adversely affect desire to quit smoking. Most PLWH were unaware of an increased risk of non-communicable respiratory illness associated with HIV, so provision of information regarding this might help to reduce tobacco use in this population.