Receipt and predictors of smoking cessation pharmacotherapy among veterans with and without HIV

Prog Cardiovasc Dis. Mar-Apr 2020;63(2):118-124. doi: 10.1016/j.pcad.2020.01.003. Epub 2020 Jan 24.

Abstract

Smoking is highly prevalent among people living with HIV (PLWH) and increases cardiovascular risk. Pharmacotherapies such as nicotine replacement therapy (NRT), bupropion, and varenicline help to reduce smoking, though rates of receipt among PLWH compared with HIV-uninfected persons are unknown. Among 814 PLWH and 908 uninfected patients enrolled in the Veterans Aging Cohort Study (2012-2017) who reported current smoking, we used marginal multivariable log-linear regression models to estimate adjusted relative risks (ARR) of receiving pharmacotherapy by HIV status. We also assessed patient-level factors associated with pharmacotherapy receipt within each group. In multivariable analyses, receipt of NRT was less likely among PLWH relative to uninfected participants (ARR 0.77, 95% CI 0.67, 0.89). In both populations, documented mental health disorders and contemplation to quit were associated with greater likelihood of receiving pharmacotherapy. Further research is needed to explore potential treatment disparities.

Keywords: HIV; Smoking; Smoking cessation; Smoking cessation pharmacotherapy; Veterans.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / therapeutic use*
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / prevention & control*
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • HIV Long-Term Survivors*
  • Health Status
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Preventive Health Services*
  • Prospective Studies
  • Protective Factors
  • Risk Assessment
  • Risk Factors
  • Risk Reduction Behavior
  • Smokers*
  • Smoking / adverse effects*
  • Smoking / epidemiology
  • Smoking Cessation
  • Smoking Cessation Agents / administration & dosage*
  • Smoking Cessation Agents / adverse effects
  • Time Factors
  • Treatment Outcome
  • United States / epidemiology
  • Veterans Health*
  • Viral Load

Substances

  • Anti-HIV Agents
  • Smoking Cessation Agents