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Tobacco use and nicotine dependence among people living with HIV who drink heavily in South Africa: a cross-sectional baseline study
BACKGROUND: People living with HIV (PLWH) who drink alcohol and use tobacco are particularly vulnerable to tobacco-induced diseases due to an already compromised immune system. This study investigated the prevalence and factors associated with tobacco use (cigarette and snuff) among PLWH who drink h...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916073/ https://www.ncbi.nlm.nih.gov/pubmed/31842834 http://dx.doi.org/10.1186/s12889-019-8047-8 |
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author | Egbe, Catherine O. Londani, Mukhethwa Parry, Charles D. H. Myers, Bronwyn Shuper, Paul A. Nkosi, Sebenzile Morojele, Neo K. |
author_facet | Egbe, Catherine O. Londani, Mukhethwa Parry, Charles D. H. Myers, Bronwyn Shuper, Paul A. Nkosi, Sebenzile Morojele, Neo K. |
author_sort | Egbe, Catherine O. |
collection | PubMed |
description | BACKGROUND: People living with HIV (PLWH) who drink alcohol and use tobacco are particularly vulnerable to tobacco-induced diseases due to an already compromised immune system. This study investigated the prevalence and factors associated with tobacco use (cigarette and snuff) among PLWH who drink heavily. METHODS: Participants (n = 623) on antiretroviral therapy for HIV who reported heavy drinking using the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-C were recruited from six hospitals in Gauteng Province, South Africa. The Fagerström test was used to assess nicotine dependence. Chi Square tests and modified Poisson regression analyses were conducted to identify factors associated with tobacco use. RESULTS: Almost half of the participants reported ever smoking (44.0%; CI: 40.1–47.9) and about a quarter reported ever using snuff (25.5%; CI: 22.2–29.1). Current smokers and current snuff users comprised 27.3% (CI: 23.9–30.9) and 19.1% (CI: 16.2–22.3) of all participants respectively. Among current smokers, 37.9% (CI: 30.8–45.3) were moderately/highly dependent on nicotine. Current ‘any tobacco product users’ (ATPU: use cigarettes or snuff) were 45.4% (CI: 41.5–49.3) while 1.0% (CI: 0.4–2.0) currently used cigarettes and snuff. Adjusted regression analyses showed that, compared to males, females were less at risk of being: ever smokers (Relative Risk Ratio [RRR] = 0.33; CI: 0.27–0.41), current smokers (RRR = 0.18; CI: 0.12–0.25), and ATPU (RRR = 0.75; CI: 0.63–0.89) but were more at risk of ever snuff use (RRR = 5.23; CI: 3.31–8.25), or current snuff use (RRR = 26.19; CI: 8.32–82.40) than males. Ever snuff users (RRR = 1.32; CI: 1.03–1.70), current snuff users (RRR = 1.40; CI: 1.03–1.89) and ATPU (RRR = 1.27; CI: 1.07–1.51) were more at risk of reporting significant depressive symptoms. We found no significant associations between smoking status and years on ART and viral load. CONCLUSION: There is a high prevalence of cigarette and snuff use among PLWH who drink heavily. Tobacco use cessation interventions tailored specifically for this population and according to their tobacco product of choice are urgently needed given their vulnerability to ill-health. |
format | Online Article Text |
id | pubmed-6916073 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-69160732019-12-30 Tobacco use and nicotine dependence among people living with HIV who drink heavily in South Africa: a cross-sectional baseline study Egbe, Catherine O. Londani, Mukhethwa Parry, Charles D. H. Myers, Bronwyn Shuper, Paul A. Nkosi, Sebenzile Morojele, Neo K. BMC Public Health Research Article BACKGROUND: People living with HIV (PLWH) who drink alcohol and use tobacco are particularly vulnerable to tobacco-induced diseases due to an already compromised immune system. This study investigated the prevalence and factors associated with tobacco use (cigarette and snuff) among PLWH who drink heavily. METHODS: Participants (n = 623) on antiretroviral therapy for HIV who reported heavy drinking using the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-C were recruited from six hospitals in Gauteng Province, South Africa. The Fagerström test was used to assess nicotine dependence. Chi Square tests and modified Poisson regression analyses were conducted to identify factors associated with tobacco use. RESULTS: Almost half of the participants reported ever smoking (44.0%; CI: 40.1–47.9) and about a quarter reported ever using snuff (25.5%; CI: 22.2–29.1). Current smokers and current snuff users comprised 27.3% (CI: 23.9–30.9) and 19.1% (CI: 16.2–22.3) of all participants respectively. Among current smokers, 37.9% (CI: 30.8–45.3) were moderately/highly dependent on nicotine. Current ‘any tobacco product users’ (ATPU: use cigarettes or snuff) were 45.4% (CI: 41.5–49.3) while 1.0% (CI: 0.4–2.0) currently used cigarettes and snuff. Adjusted regression analyses showed that, compared to males, females were less at risk of being: ever smokers (Relative Risk Ratio [RRR] = 0.33; CI: 0.27–0.41), current smokers (RRR = 0.18; CI: 0.12–0.25), and ATPU (RRR = 0.75; CI: 0.63–0.89) but were more at risk of ever snuff use (RRR = 5.23; CI: 3.31–8.25), or current snuff use (RRR = 26.19; CI: 8.32–82.40) than males. Ever snuff users (RRR = 1.32; CI: 1.03–1.70), current snuff users (RRR = 1.40; CI: 1.03–1.89) and ATPU (RRR = 1.27; CI: 1.07–1.51) were more at risk of reporting significant depressive symptoms. We found no significant associations between smoking status and years on ART and viral load. CONCLUSION: There is a high prevalence of cigarette and snuff use among PLWH who drink heavily. Tobacco use cessation interventions tailored specifically for this population and according to their tobacco product of choice are urgently needed given their vulnerability to ill-health. BioMed Central 2019-12-16 /pmc/articles/PMC6916073/ /pubmed/31842834 http://dx.doi.org/10.1186/s12889-019-8047-8 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Egbe, Catherine O. Londani, Mukhethwa Parry, Charles D. H. Myers, Bronwyn Shuper, Paul A. Nkosi, Sebenzile Morojele, Neo K. Tobacco use and nicotine dependence among people living with HIV who drink heavily in South Africa: a cross-sectional baseline study |
title | Tobacco use and nicotine dependence among people living with HIV who drink heavily in South Africa: a cross-sectional baseline study |
title_full | Tobacco use and nicotine dependence among people living with HIV who drink heavily in South Africa: a cross-sectional baseline study |
title_fullStr | Tobacco use and nicotine dependence among people living with HIV who drink heavily in South Africa: a cross-sectional baseline study |
title_full_unstemmed | Tobacco use and nicotine dependence among people living with HIV who drink heavily in South Africa: a cross-sectional baseline study |
title_short | Tobacco use and nicotine dependence among people living with HIV who drink heavily in South Africa: a cross-sectional baseline study |
title_sort | tobacco use and nicotine dependence among people living with hiv who drink heavily in south africa: a cross-sectional baseline study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916073/ https://www.ncbi.nlm.nih.gov/pubmed/31842834 http://dx.doi.org/10.1186/s12889-019-8047-8 |
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