Abstract
Background Persons with HIV (PWH) smoke cigarettes at much higher rates than the general population in the US, and smoking is now the leading cause of death in US PWH. Efforts to control the tobacco use epidemic in PWH have met with limited success, and the factors associated with successful cessation are not well delineated. There is a particular dearth of knowledge regarding PWH ex-smokers who have successfully quit smoking cigarettes for the long term. Methods We pooled data from three separate sources of PWH smokers and ex-smokers (reporting complete abstinence for ≥ one year with biochemical verification at the time of data collection) from New York City, collected sociodemographic and behavioral information from them in structured interviews, and obtained their DNA samples. Univariate and rigorous multivariate analytic strategies were employed to determine the sociobehavioral and genetic factors that distinguished PWH smokers from ex-smokers. Results We compared 142 current/recent smokers to 52 biochemically confirmed ex-smokers. The mean age of the participants was 53.3 ± 9.9 years, 49.5% were female, and 76.3% were Black/African American. Successful quitters had significantly lower anxiety scores and were less likely to report hazardous alcohol use or to use marijuana or cocaine. On multivariate analysis utilizing a conservative analytic approach, of 156 single nucleotide variants (SNV) within 12 a priori candidate genes, only the 37148248 T->C variant of gene SLC25A21 on chromosome 14 was associated with long-term cessation. Conclusions In this study, we report behavioral variables associated with long-term abstinence in PWH ex-smokers, and we also report the first genetic correlation of successful cessation in a PWH population yet described.
Highlights
Half of all persons living with HIV (PWH) in the United States (US) are active cigarette smokers [1, 2], and smoking has emerged as the leading cause of death in this group [3]
Group 1: individuals who enrolled between May 2014 and August 2017 into a randomized controlled trial of Positively Smoke Free group therapy, our eight-session intensive behavioral tobacco treatment developed for Persons with HIV (PWH) smokers which was described in a prior publication [8]
We developed a custom next-generation sequencing (NGS) panel to map single-nucleotide variants (SNVs) in known exons and their promoter regions, of 12 candidate genes previously associated with tobacco use, addiction, and risk-taking behaviors (Supplemental Table I)
Summary
Half of all persons living with HIV (PWH) in the United States (US) are active cigarette smokers [1, 2], and smoking has emerged as the leading cause of death in this group [3]. Numerous different tobacco treatment strategies have been employed in PWH with the goal of promoting cessation. The factors that are associated with successful cessation, especially those with long-term cessation, in PWH smokers are not well-defined. Accurate profiles of those PWH smokers with a good chance of achieving cessation with tobacco treatment and of those with a poor chance could help the medical establishment better direct scarce resources. We report behavioral variables associated with long-term abstinence in PWH ex-smokers, and we report the first genetic correlation of successful cessation in a PWH population yet described
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