Rennatus Mdodo, DrPH, MS; Emma L. Frazier, PhD, MS; Shanta R. Dube, PhD, MPH; Christine L. Mattson, PhD; Madeline Y. Sutton, MD, MPH; John T. Brooks, MD; Jacek Skarbinski, MD
Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.
Acknowledgment: The authors thank all MMP and NHIS participants and staff members for their time and efforts. They also thank Dr. Yunfeng (Tracy) Tie for MMP data analytic support and Ms. Kat Asman, MSPH, for NHIS data analytic support.
Grant Support: By the CDC (cooperative agreement PS09-937 with MMP participating areas).
Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-0954.
Reproducible Research Statement:Study protocol: The MMP protocol is available at www.cdc.gov/hiv/statistics/systems/mmp/resources.html. The NHIS survey description and methodology are available at ftp://ftp.cdc.gov/pub/Health_Statis tics/NCHS/Dataset_Documentation/NHIS/2009/srvydesc.pdf. Statistical code: Available from Dr. Sutton (e-mail, email@example.com). Data set: The MMP data sets are not available. The NHIS data sets are available at www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm.
Requests for Single Reprints: Madeline Y. Sutton, MD, MPH, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Office of Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Mail Stop E-45, Atlanta, GA 30329; e-mail, firstname.lastname@example.org.
Current Author Addresses: Drs. Mdodo, Sutton, and Brooks: Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Office of Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Mail Stop E-45, Atlanta, GA 30329.
Drs. Frazier, Mattson, and Skarbinski: Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Office of Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Mail Stop E-46, Atlanta, GA 30329.
Dr. Dube: Associate Professor, Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, 1 Park Place, Suite 711, Atlanta, GA 30303.
Author Contributions: Conception and design: R. Mdodo, C.L. Mattson, M.Y. Sutton, J.T. Brooks, J. Skarbinski.
Analysis and interpretation of the data: R. Mdodo, E.L. Frazier, S.R. Dube, C.L. Mattson, M.Y. Sutton, J.T. Brooks, J. Skarbinski.
Drafting of the article: R. Mdodo, E.L. Frazier, S.R. Dube, C.L. Mattson, M.Y. Sutton, J.T. Brooks, J. Skarbinski.
Critical revision of the article for important intellectual content: R. Mdodo, S.R. Dube, C.L. Mattson, M.Y. Sutton, J.T. Brooks, J. Skarbinski.
Final approval of the article: E.L. Frazier, S.R. Dube, C.L. Mattson, M.Y. Sutton, J.T. Brooks, J. Skarbinski.
Statistical expertise: R. Mdodo, E.L. Frazier, C.L. Mattson.
Obtaining of funding: J. Skarbinski.
Collection and assembly of data: S.R. Dube, E.L. Frazier, C.L. Mattson, J. Skarbinski.
Mdodo R, Frazier EL, Dube SR, Mattson CL, Sutton MY, Brooks JT, et al. Cigarette Smoking Prevalence Among Adults With HIV Compared With the General Adult Population in the United States: Cross-sectional Surveys. Ann Intern Med. 2015;162:335-344. doi: 10.7326/M14-0954
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Published: Ann Intern Med. 2015;162(5):335-344.
The negative health effects of cigarette smoking and HIV infection are synergistic.
To compare the prevalence of current cigarette smoking and smoking cessation between adults with HIV receiving medical care and adults in the general population.
Nationally representative cross-sectional surveys.
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.
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).
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.
Cross-sectional design with some generalizability limitations.
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.
Centers for Disease Control and Prevention.
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Cardiology, Infectious Disease, HIV, Tobacco, Alcohol, and Other Substance Abuse, Coronary Risk Factors.
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