Helia Shariati1, Heather L Armstrong2, Zishan Cui3, Nathan J Lachowsky4, Julia Zhu5, Praney Anand6, Eric A Roth7, Robert S Hogg8, Greg Oudman9, Christina Tonella10, David M Moore11. 1. Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, V6T 1Z3, Canada. Electronic address: heliashariati@hotmail.com. 2. Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, V6T 1Z3, Canada; British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St., Vancouver, V6Z 1Y6, Canada. Electronic address: harmstrong@cfenet.ubc.ca. 3. British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St., Vancouver, V6Z 1Y6, Canada. Electronic address: zcui@cfenet.ubc.ca. 4. British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St., Vancouver, V6Z 1Y6, Canada; School of Public Health & Social Policy, University of Victoria, B202-3800 Finnerty Road, Victoria, V8P 5C2, Canada; Centre for Addictions Research of British Columbia, University of Victoria, 2300 McKenzie Ave, Victoria, V8N 5M8, Canada. Electronic address: nlachowsky@cfenet.ubc.ca. 5. British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St., Vancouver, V6Z 1Y6, Canada. Electronic address: jzhu@cfenet.ubc.ca. 6. British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St., Vancouver, V6Z 1Y6, Canada. Electronic address: anand.praney@gmail.com. 7. Centre for Addictions Research of British Columbia, University of Victoria, 2300 McKenzie Ave, Victoria, V8N 5M8, Canada; Department of Anthropology, University of Victoria, B228-3800 Finnerty Road, Victoria, V8P5C2, Canada. Electronic address: ericroth@uvic.ca. 8. British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St., Vancouver, V6Z 1Y6, Canada; Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, V5A 1S6, Canada. Electronic address: bobhogg@cfenet.ubc.ca. 9. Health Initiative for Men, 421-1033 Davie St., Vancouver, V6E 1M7, Canada. Electronic address: greg@checkhimout.ca. 10. Vancouver Coastal Health, 1200-601 West Broadway, Vancouver, V7G 1J6, Canada. Electronic address: Christina.tonella@vch.ca. 11. Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, V6T 1Z3, Canada; British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St., Vancouver, V6Z 1Y6, Canada. Electronic address: dmoore@cfenet.ubc.ca.
Abstract
BACKGROUND: Cigarette smoking is common among gay, bisexual, and other men who have sex with men (GBMSM) and most of the mortality gap between HIV-positive and HIV-negative individuals is attributable to smoking. METHODS: We recruited sexually active HIV-positive and HIV-negative GBMSM age ≥16 years using respondent-driven sampling. Study visits occurred every six months for up to four years and included a computer-assisted self-interview and clinical assessment. We conducted bivariate analyses to compare factors associated with "never", "former", "daily", or "non-daily" smoking at baseline and longitudinal mixed effects models to examine factors associated with cessation and (re)initiation. RESULTS: 774 participants completed a baseline visit and 525 enrolled in the cohort and completed at least one follow-up visit. At baseline, the median age was 34 years and 31.5% were daily smokers. In follow-up (median=2.5years), 116 daily or non-daily smokers (41%) quit at least once and of these, 101 (87%) remained former smokers at their last visit. Smoking cessation was positively associated with incomes ≥$60,000 and self-reported excellent health. Alcohol use, ecstasy use, and having a partner who smokes were associated with decreased odds of cessation. Substance use (cannabis, GHB, and crystal methamphetamine) and having a partner who smokes were positively associated with increasing to/resuming daily smoking. HIV-positive GBMSM were more likely to smoke but not more likely to quit. CONCLUSIONS: Targeted, culturally relevant smoking cessation resources are needed, especially for HIV-positive GBMSM. Engaging couples in cessation interventions may be useful.
BACKGROUND: Cigarette smoking is common among gay, bisexual, and other men who have sex with men (GBMSM) and most of the mortality gap between HIV-positive and HIV-negative individuals is attributable to smoking. METHODS: We recruited sexually active HIV-positive and HIV-negative GBMSM age ≥16 years using respondent-driven sampling. Study visits occurred every six months for up to four years and included a computer-assisted self-interview and clinical assessment. We conducted bivariate analyses to compare factors associated with "never", "former", "daily", or "non-daily" smoking at baseline and longitudinal mixed effects models to examine factors associated with cessation and (re)initiation. RESULTS: 774 participants completed a baseline visit and 525 enrolled in the cohort and completed at least one follow-up visit. At baseline, the median age was 34 years and 31.5% were daily smokers. In follow-up (median=2.5years), 116 daily or non-daily smokers (41%) quit at least once and of these, 101 (87%) remained former smokers at their last visit. Smoking cessation was positively associated with incomes ≥$60,000 and self-reported excellent health. Alcohol use, ecstasy use, and having a partner who smokes were associated with decreased odds of cessation. Substance use (cannabis, GHB, and crystal methamphetamine) and having a partner who smokes were positively associated with increasing to/resuming daily smoking. HIV-positive GBMSM were more likely to smoke but not more likely to quit. CONCLUSIONS: Targeted, culturally relevant smoking cessation resources are needed, especially for HIV-positive GBMSM. Engaging couples in cessation interventions may be useful.
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