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Systematic identification and referral of smokers attending HIV ambulatory care highlights the failure of current service provision in an at-risk population

INTRODUCTION: People living with HIV (PLWH) are more likely to smoke than the general population and are at greater risk of smoking-related illness. Healthcare services need to address this burden of preventable disease. METHODS: We evaluated the impact of a brief intervention that asked service use...

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Autores principales: Brown, James, Kyriacou, Christianna, Pickett, Elisha, Edwards, Kelly, Joshi, Hemal, Stewart, Nafeesah, Melville, Andrew, Johnson, Margaret, Flint, Jan, Bartley, Angela, Rodger, Alison, Lipman, Marc
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6797406/
https://www.ncbi.nlm.nih.gov/pubmed/31673360
http://dx.doi.org/10.1136/bmjresp-2018-000395
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author Brown, James
Kyriacou, Christianna
Pickett, Elisha
Edwards, Kelly
Joshi, Hemal
Stewart, Nafeesah
Melville, Andrew
Johnson, Margaret
Flint, Jan
Bartley, Angela
Rodger, Alison
Lipman, Marc
author_facet Brown, James
Kyriacou, Christianna
Pickett, Elisha
Edwards, Kelly
Joshi, Hemal
Stewart, Nafeesah
Melville, Andrew
Johnson, Margaret
Flint, Jan
Bartley, Angela
Rodger, Alison
Lipman, Marc
author_sort Brown, James
collection PubMed
description INTRODUCTION: People living with HIV (PLWH) are more likely to smoke than the general population and are at greater risk of smoking-related illness. Healthcare services need to address this burden of preventable disease. METHODS: We evaluated the impact of a brief intervention that asked service users about smoking when they attended for ambulatory HIV care in London, UK, and offered referral to smoking cessation. RESULTS: Overall, 1548 HIV-positive individuals were asked about their smoking status over a 12-month period. Of this group, 385 (25%) reported that they were current smokers, 372 (97%) were offered referral to smoking cessation services and 154 (40%) accepted this. We established an outcome of referral for 114 (74%) individuals. A total of 36 (10% of smokers) attended stop smoking clinics and 16 (4%) individuals were recorded as having quit smoking. DISCUSSION: The simple intervention of asking PLWH about tobacco smoking and offering referral to smoking cessation services rapidly identified current smokers, 40% of whom accepted referral to smoking cessation services. This highlights the importance of promoting behaviour and lifestyle changes with every contact with health services. However, a large proportion of those referred were either not seen in local services or the outcome of referral could not be ascertained. If the risk of smoking-related morbidity among PLWH is to be reduced, more sustainable referral pathways and ways of improving uptake of smoking cessation services must be developed.
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spelling pubmed-67974062019-10-31 Systematic identification and referral of smokers attending HIV ambulatory care highlights the failure of current service provision in an at-risk population Brown, James Kyriacou, Christianna Pickett, Elisha Edwards, Kelly Joshi, Hemal Stewart, Nafeesah Melville, Andrew Johnson, Margaret Flint, Jan Bartley, Angela Rodger, Alison Lipman, Marc BMJ Open Respir Res Smoking INTRODUCTION: People living with HIV (PLWH) are more likely to smoke than the general population and are at greater risk of smoking-related illness. Healthcare services need to address this burden of preventable disease. METHODS: We evaluated the impact of a brief intervention that asked service users about smoking when they attended for ambulatory HIV care in London, UK, and offered referral to smoking cessation. RESULTS: Overall, 1548 HIV-positive individuals were asked about their smoking status over a 12-month period. Of this group, 385 (25%) reported that they were current smokers, 372 (97%) were offered referral to smoking cessation services and 154 (40%) accepted this. We established an outcome of referral for 114 (74%) individuals. A total of 36 (10% of smokers) attended stop smoking clinics and 16 (4%) individuals were recorded as having quit smoking. DISCUSSION: The simple intervention of asking PLWH about tobacco smoking and offering referral to smoking cessation services rapidly identified current smokers, 40% of whom accepted referral to smoking cessation services. This highlights the importance of promoting behaviour and lifestyle changes with every contact with health services. However, a large proportion of those referred were either not seen in local services or the outcome of referral could not be ascertained. If the risk of smoking-related morbidity among PLWH is to be reduced, more sustainable referral pathways and ways of improving uptake of smoking cessation services must be developed. BMJ Publishing Group 2019-10-03 /pmc/articles/PMC6797406/ /pubmed/31673360 http://dx.doi.org/10.1136/bmjresp-2018-000395 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Smoking
Brown, James
Kyriacou, Christianna
Pickett, Elisha
Edwards, Kelly
Joshi, Hemal
Stewart, Nafeesah
Melville, Andrew
Johnson, Margaret
Flint, Jan
Bartley, Angela
Rodger, Alison
Lipman, Marc
Systematic identification and referral of smokers attending HIV ambulatory care highlights the failure of current service provision in an at-risk population
title Systematic identification and referral of smokers attending HIV ambulatory care highlights the failure of current service provision in an at-risk population
title_full Systematic identification and referral of smokers attending HIV ambulatory care highlights the failure of current service provision in an at-risk population
title_fullStr Systematic identification and referral of smokers attending HIV ambulatory care highlights the failure of current service provision in an at-risk population
title_full_unstemmed Systematic identification and referral of smokers attending HIV ambulatory care highlights the failure of current service provision in an at-risk population
title_short Systematic identification and referral of smokers attending HIV ambulatory care highlights the failure of current service provision in an at-risk population
title_sort systematic identification and referral of smokers attending hiv ambulatory care highlights the failure of current service provision in an at-risk population
topic Smoking
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6797406/
https://www.ncbi.nlm.nih.gov/pubmed/31673360
http://dx.doi.org/10.1136/bmjresp-2018-000395
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