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Am J Prev Med. 2014 Jul;47(1):53-69. doi: 10.1016/j.amepre.2014.02.010. Epub 2014 Apr 18.

Smoking cessation and recidivism in the Women's Interagency Human Immunodeficiency Virus Study.

Author information

1
Department of Clinical Pharmacy , University of California, San Francisco. Electronic address: Nancy.Hessol@ucsf.edu.
2
CORE Center, Cook County Health and Hospital System and Rush University, Chicago, Illinois.
3
Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
4
Department of Community Health Sciences, School of Public Health, State University of New York Downstate Medical Center, Brooklyn.
5
Georgetown University School of Medicine, Washington DC.
6
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
7
Division of Internal Medicine , Montefiore Medical Center, Bronx, New York.
8
Department of Medicine, University of California, San Francisco.
9
CORE Center, Cook County Health and Hospital System and Rush University, Chicago, Illinois; Department of Medicine, Cook County Health and Hospital System and Rush University, Chicago, Illinois.

Abstract

BACKGROUND:

Smoking increases the risk of morbidity and mortality and is particularly harmful to HIV-infected people.

PURPOSE:

To explore smoking trends and longitudinal factors associated with smoking cessation and recidivism among participants in the Women's Interagency HIV Study.

METHODS:

From 1994 through 2011, a total of 2,961 HIV-infected and 981 HIV-uninfected women were enrolled and underwent semi-annual interviews and specimen collection. Smoking prevalence was evaluated annually and risk factors associated with time to smoking cessation and recidivism were analyzed in 2013 using survival models.

RESULTS:

The annual cigarette smoking prevalence declined from 57% in 1995 to 39% in 2011 (p-trend<0.0001). Among smokers, factors significantly associated with a longer time to smoking cessation included less education, alcohol use, having health insurance, >10-year smoking duration, self-reported poor health rating, and having hypertension. Pregnancy in the past 6 months was associated with a shorter time to cessation. Among HIV-infected women, additional risk factors for longer time to cessation included lower household income, use of crack/cocaine/heroin, CD4 cell count ≤200, and highly active antiretroviral therapy (HAART) use. Predictors of smoking recidivism included marijuana use, enrollment in 1994-1996, and not living in one's own place. Among HIV-infected women, enrollment in 2001-2002 and crack/cocaine/heroin use were associated with a shorter time to recidivism, whereas older age and HAART use were associated with a longer time to recidivism.

CONCLUSIONS:

Despite declining rates of cigarette smoking, integrated interventions are needed to help women with and at risk for HIV infection to quit smoking and sustain cessation.

PMID:
24746376
PMCID:
PMC4065848
DOI:
10.1016/j.amepre.2014.02.010
[Indexed for MEDLINE]
Free PMC Article
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