Characteristics of intermittent smokers and their association with quit intentions in a sample of heavy-drinking HIV-infected men who have sex with men.

Intermittent smokers (ITS) have increased health risks compared with non-smokers (NS). Cigarette smoking remains prevalent among men who have sex with men (MSM) and persons living with HIV (PLWH), yet most studies in PLWH do not discriminate between daily smokers (DS) and ITS. In this study, the characteristics and quit intentions of ITS and DS are compared in a sample of heavy-drinking HIV-infected MSM. Of the 185 participants enrolled, 49.2% reported having smoked cigarettes in the past month; among those, 50.5% were DS, and 49.5% were ITS. Compared with DS, ITS were significantly more likely to be White and to have a college degree or higher. DS reported significantly higher average number of drinks per week compared with both ITS and NS. Compared with DS, ITS were significantly more likely to report future quit intentions (i.e., within 6 months or more) compared to no intentions at all; DS were more likely to report immediate quit intentions (i.e., within 30 days) compared to future quit intentions. Among heavy-drinking MSM living with HIV, intermittent smoking was associated with being White, college educated, and having future quit intentions. Considering that smoking in ITS may be less driven by nicotine dependence, tailored approaches to smoking cessation may be needed. Specifically, it may be important for interventions for ITS to address social and situational cues to smoke, including the influence of heavy alcohol use on smoking behaviors, and to provide information regarding the adverse health effects of even low-level smoking.