Abstract
BackgroundTobacco use is a leading cause of preventable diseases and death for all individuals, even more so for people living with HIV (PLWH), due to their status of chronic inflammation. To date, in Italy no study was performed to compare smoking habits in PLWH and the general population. We aimed to investigate smoking habits in PLWH, as compared to the general population.MethodsMulti-center cross-sectional study. Smoking habits were compared between PLWH and the general population. PLWH were enrolled in the STOPSHIV Study. The comparison group from the general population was derived from a survey performed by the National Statistics Institute (ISTAT), with a stratified random sampling procedure matching 2:1 general population subjects with PLWH by age class, sex, and macro-area of residence.ResultsThe total sample consisted of 1087 PLWH (age 47.9 ± 10.8 years, male 73.5%) and 2218 comparable subjects from the general population. Prevalence of current smokers was 51.6% vs 25.9% (p < 0.001); quitting smoking rate was 27.1% vs. 50.1% (p < 0.001) and the mean number of cigarettes smoked per day was 15.8 vs. 11.9 (p < 0.001), respectively for PLWH and the general population. Smoking and heavy smoking rates amongst PLWH were significantly higher even in subjects who reported diabetes, hypertension and extreme obesity (p < 0.001). Logistic regressions showed that PLWH were more likely current smokers (adjusted Odds Ratio, aOR = 3.11; 95% Confidence Interval (CI) =2.62–3.71; p < 0.001) and heavy smokers (> 20 cigarettes per day) (aOR = 4.84; 95% CI = 3.74–6.27; p < 0.001). PLWH were less likely to have quitted smoking (aOR = 0.36; 95% CI = 0.29–0.46; p < 0.001).ConclusionHIV-infected patients showed a higher rate of current smokers, a larger number of cigarettes smoked and a lower quitting rate than the general population. Our findings emphasize the need for smoking cessation strategies targeting HIV persons.
Highlights
Tobacco use is a leading cause of preventable diseases and death for all individuals, even more so for people living with HIV (PLWH), due to their status of chronic inflammation
Since cigarette smoking is a relevant risk factor for these diseases, and life expectancy for smokers is at least 10 years shorter than for nonsmokers [5], cigarette smoking is a major concern for PLWH
We examined the characteristics of smoking habits in a sample of PLWH from Italy, enrolled in a study on smoking prevalence and cessation (STOPSHIV study) [13, 14], and in a matched comparison sample from the Italian general population, selected from a survey performed by the National Statistics Institute (ISTAT) [15]
Summary
Tobacco use is a leading cause of preventable diseases and death for all individuals, even more so for people living with HIV (PLWH), due to their status of chronic inflammation. Over the past two decades, HIV-associated morbidity and mortality rates have dramatically declined and the life expectancy of people living with HIV (PLWH) has considerably increased, due to effective antiretroviral therapy (ART). Since cigarette smoking is a relevant risk factor for these diseases, and life expectancy for smokers is at least 10 years shorter than for nonsmokers [5], cigarette smoking is a major concern for PLWH. PLWH who receive optimal ART and other health care interventions appear to lose more life years due to tobacco smoking than to HIV infection [6]. Identifying and appropriately managing smokers with HIV infection is a relevant clinical issue and current medical guidelines for PLWH mandate preventive interventions for lifestyle modification to improve their prognosis [10]
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