Barriers and Facilitators of Smoking Cessation among Latinos Living with HIV: Perspectives from Key Leaders of Community-Based Organizations and Clinics.

Surina Chock,Michelle Lee D’Abundo,Francisco Cartujano-Barrera,Charles S Kamen,Pamela Valera,Ana Paula Cupertino,Evelyn Arana-Chicas

doi:10.3390/ijerph18073437

Abstract

The purpose of this study was to identify the perspectives from key leaders of community-based organizations (CBOs) and clinics serving people living with HIV on barriers and facilitators of smoking cessation among Latino smokers living with HIV. Semi-structured interviews were conducted in English and Spanish with 10 key leaders. Using a social ecological model, qualitative theoretical analysis was used to analyze the results. Participants identified barriers at the individual (e.g., low education level, HIV, and financial stress), interpersonal (e.g., language barriers, low social support), organizational (e.g., lack of smoking cessation resources and targeted interventions), community (e.g., HIV and mental health stigma), and policy (e.g., paperwork for insurance) level. Participants identified facilitators at the individual (e.g., high participation in trials, good medication adherence), interpersonal (e.g., no smoking in social circles), organizational (e.g., bilingual staff, culturally competent care), community (e.g., providing transportation, the coronavirus disease 2019 as an opportunity for smoking cessation), and policy level (e.g., existence of funding, comprehensive insurance programs). These results provide operational strategies to address smoking disparities among Latino smokers living with HIV. Further research is needed on how to integrate these perspectives into effective smoking cessation interventions.

Highlights

Tobacco use remains the leading preventable cause of disease and death among Latinos [1], the largest racial and ethnic minority group in the United States (U.S.) [2]
Key leaders of communitybased organizations (CBOs) and clinics perceived 10 individual barriers of smoking cessation among Latinos living with HIV: (1) low education level, (2) financial stress, (3) HIV stress, (4) minimal understanding of the benefits of quitting smoking, (5) minimal interest in smoking cessation counseling, (6) minimal interest in smoking cessation medications, (7) smoking and mood management, (8) smoking and weight management, (9) alcoholism and other substance use disorders, and (10) low self-worth
Key leaders of CBOs and clinics identified HIV and mental health stigma as community barriers of smoking cessation among Latinos living with HIV

Summary

Introduction

Tobacco use remains the leading preventable cause of disease and death among Latinos [1], the largest racial and ethnic minority group in the United States (U.S.) [2]. The ethnic terms Hispanic or Latino refer to a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race [2]. The majority of Latinos experience multiple barriers to healthcare access and treatment that result in tobacco-related disparities. Compared to non-Hispanic Blacks and Whites, Latinos are less likely to receive advice to quit, participate in smoking cessation programs, and use pharmacotherapy for smoking cessation [4,5,6,7,8,9].

Objectives

Results

Discussion

Conclusion