Smoking and cessation treatment among persons with and without HIV in a US integrated health system
Smoking and cessation treatment among persons with and without HIV in a US integrated health system
复制标题
DOI：
10.1016/j.drugalcdep.2020.108128
复制
发表时间：
2020-08-01
影响因子：
4.2
通讯作者：
Silverberg, Michael J.
中科院分区：
文献类型：
--
作者：
Lam, Jennifer O.;Levine-Hall, Tory;Silverberg, Michael J.
背景：艾滋病毒感染者（PWH）比没有艾滋病毒的人更容易吸烟，更容易受到吸烟的有害影响。我们检查了美国综合卫生系统中PWH和非HIV患者的吸烟模式和戒烟治疗的使用情况。方法：选取2013年7月至2017年12月期间感染艾滋病毒的成年人（>= 18岁）和人口统计学匹配的未感染艾滋病毒的人。从健康记录中确定吸烟状况和戒烟治疗。我们计算了年龄标准化的年吸烟率，并使用cochrana - armitage检验和泊松回归评估趋势。研究期间与戒烟治疗相关的因素，以及研究最后一年的吸烟情况，使用多变量泊松模型通过HIV状态进行评估。结果：该研究包括11,235名PWH和227,320名未感染艾滋病毒的人。在所有年份中，PWH人群的吸烟率较高，但两组的吸烟率均有所下降（PWH人群从16.6%降至14.6%，未感染艾滋病毒人群从11.6%降至10.5%）。在吸烟者中，与未感染艾滋病毒的人相比，PWH更有可能开始戒烟治疗（17.9% vs. 13.3%，协变量校正患病率为1.31,95% CI = 1.15-1.50）， PWH亚组之间的戒烟治疗差异不大。2017年，PWH的吸烟率仍然较高，尤其是在年轻人或被诊断为抑郁症或物质使用障碍的人群中。结论：在获得戒烟资源的环境中，PWH和非HIV人群的吸烟率均有所下降。PWH有更多的戒烟治疗，这是令人鼓舞的减少吸烟和改善健康。
Background: Persons with HIV (PWH) are more likely to smoke and are more susceptible to the harmful effects of smoking than persons without HIV. We examined smoking patterns and use of cessation treatment among PWH and persons without HIV in a U.S. integrated health system.Methods: We identified adults (>= 18 years) with HIV and demographically-matched persons without HIV between July 2013 and December 2017. Smoking status and cessation treatment were ascertained from health records. We calculated age-standardized annual prevalence of smoking and evaluated trends using Cochran-Armitage tests and Poisson regression. Factors associated with cessation treatment during the study period, and smoking in the last year of the study, were evaluated by HIV status using multivariable Poisson models.Results: The study included 11,235 PWH and 227,320 persons without HIV. Smoking prevalence was higher among PWH across all years but declined for both groups (from 16.6% to 14.6% in PWH and 11.6% to 10.5% in persons without HIV). Among smokers, PWH were more likely to initiate cessation treatment compared to persons without HIV (17.9% vs. 13.3%, covariate-adjusted prevalence ratio of 1.31, 95% CI = 1.15-1.50), with few differences in cessation treatment across subgroups of PWH. In 2017, smoking prevalence remained higher in PWH, especially among those who were younger or who had diagnoses of depression or substance use disorder.Conclusion: In a setting with access to cessation resources, smoking prevalence decreased both in PWH and persons without HIV. PWH had greater uptake of cessation treatment, which is encouraging for smoking reduction and improved health.