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...

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Main Authors: Egbe, C.O., Londani, M., Parry, C.D.H., Myers-Franchi, Bronwyn, Shuper, P.A., Nkosi, S., Morojele, N.K.
Format: Journal Article
Language:English
Published: BMC 2019
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/85656
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author Egbe, C.O.
Londani, M.
Parry, C.D.H.
Myers-Franchi, Bronwyn
Shuper, P.A.
Nkosi, S.
Morojele, N.K.
author_facet Egbe, C.O.
Londani, M.
Parry, C.D.H.
Myers-Franchi, Bronwyn
Shuper, P.A.
Nkosi, S.
Morojele, N.K.
author_sort Egbe, C.O.
building Curtin Institutional Repository
collection Online Access
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.
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spelling curtin-20.500.11937-856562021-10-21T03:25:32Z Tobacco use and nicotine dependence among people living with HIV who drink heavily in South Africa: A cross-sectional baseline study Egbe, C.O. Londani, M. Parry, C.D.H. Myers-Franchi, Bronwyn Shuper, P.A. Nkosi, S. Morojele, N.K. Science & Technology Life Sciences & Biomedicine Public, Environmental & Occupational Health People living with HIV Tobacco use Heavy drinkers South Africa SMOKING-CESSATION INTERVENTIONS SMOKELESS TOBACCO ALCOHOL-USE LOW-INCOME RISK DISORDERS 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. 2019 Journal Article http://hdl.handle.net/20.500.11937/85656 10.1186/s12889-019-8047-8 English http://creativecommons.org/licenses/by/4.0/ BMC fulltext
spellingShingle Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
People living with HIV
Tobacco use
Heavy drinkers
South Africa
SMOKING-CESSATION INTERVENTIONS
SMOKELESS TOBACCO
ALCOHOL-USE
LOW-INCOME
RISK
DISORDERS
Egbe, C.O.
Londani, M.
Parry, C.D.H.
Myers-Franchi, Bronwyn
Shuper, P.A.
Nkosi, S.
Morojele, N.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 Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
People living with HIV
Tobacco use
Heavy drinkers
South Africa
SMOKING-CESSATION INTERVENTIONS
SMOKELESS TOBACCO
ALCOHOL-USE
LOW-INCOME
RISK
DISORDERS
url http://hdl.handle.net/20.500.11937/85656