Cigarette Smoking Prevalence Among Adults With HIV Compared With the General Adult Population in the United States
Cigarette Smoking Prevalence Among Adults With HIV Compared With the General Adult Population in the United States
复制标题
DOI：
10.7326/m14-0954
复制
发表时间：
2015-03-03
影响因子：
39.2
通讯作者：
Skarbinski, Jacek
中科院分区：
文献类型：
--
作者：
Mdodo, Rennatus;Frazier, Emma L.;Skarbinski, Jacek
背景：吸烟和HIV感染对健康的负面影响是协同作用的。目的：比较接受医疗护理的成人HIV感染者和一般人群中的成年人吸烟和戒烟的现状。设计：具有全国代表性的横断面调查。单位：美国。患者：参加医学监测项目的4217名成年HIV感染者和参加2009年全国健康访谈调查的27731名美国成年人。测量：主要暴露于吸烟。结果：在接受医疗治疗的419945名成人HIV感染者中，42.4%(95%CI，39.7%至45.1%)为现在吸烟者，20.3%(CI，18.6%至22.1%)为既往吸烟者，37.3%(CI，34.9%至39.6%)从不吸烟。2009年，美国估计有20.6%的成年人吸烟，与之相比，艾滋病毒携带者吸烟的可能性几乎是美国成年人的两倍(调整后的流行率差异，17.0个百分点[CI，14.0到20.1个百分点])，但戒烟的可能性较小(戒烟率，32.4%对51.7%)。在HIV携带者中，与吸烟率较高的独立相关因素有年龄较大、非西班牙裔白人或非西班牙裔黑人、较低教育水平、贫困、无家可归、监禁、吸毒、酗酒、抑郁以及没有达到抑制的HIV病毒载量。限制：横断面设计，有一定的概括性限制。结论：与一般成年人相比，HIV携带者吸烟的可能性更大，戒烟的可能性更小。烟草筛查和戒烟策略是常规艾滋病毒护理的重要考虑因素。
Background: The negative health effects of cigarette smoking and HIV infection are synergistic.Objective: To compare the prevalence of current cigarette smoking and smoking cessation between adults with HIV receiving medical care and adults in the general population.Design: Nationally representative cross-sectional surveys. Setting: United States.Patients: 4217 adults with HIV who participated in the Medical Monitoring Project and 27 731 U.S. adults who participated in the National Health Interview Survey in 2009.Measurements: The main exposure was cigarette smoking. The outcome measures were weighted prevalence of cigarette smoking and quit ratio (ratio of former smokers to the sum of former and current smokers).Results: Of the estimated 419 945 adults with HIV receiving medical care, 42.4% (95% CI, 39.7% to 45.1%) were current cigarette smokers, 20.3% (CI, 18.6% to 22.1%) were former smokers, and 37.3% (CI, 34.9% to 39.6%) had never smoked. Compared with the U.S. adult population, in which an estimated 20.6% of adults smoked cigarettes in 2009, adults with HIV were nearly twice as likely to smoke (adjusted prevalence difference, 17.0 percentage points [CI, 14.0 to 20.1 percentage points]) but were less likely to quit smoking (quit ratio, 32.4% vs. 51.7%). Among adults with HIV, factors independently associated with greater smoking prevalence were older age, non-Hispanic white or non-Hispanic black race, lower educational level, poverty, homelessness, incarceration, substance use, binge alcohol use, depression, and not achieving a suppressed HIV viral load.Limitation: Cross-sectional design with some generalizability limitations.Conclusion: Adults with HIV were more likely to smoke and less likely to quit smoking than the general adult population. Tobacco screening and cessation strategies are important considerations as part of routine HIV care.