1
|
Cioe PA, Schnoll R, Hoeppner BB, Gross R, Hitsman BL, Leone FT, Ashare R, Vilardaga R, Tashima K, Pinkston M, Kahler CW. The Impact of the COVID-19 Pandemic on Stress, Isolation, Smoking Behaviors, and Motivation to Quit in People with HIV Who Smoke. AIDS Behav 2023; 27:1862-1869. [PMID: 36357808 PMCID: PMC9649403 DOI: 10.1007/s10461-022-03917-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 11/12/2022]
Abstract
People with HIV (PWH) smoke at higher rates compared with the general population and have lower cessation rates. The primary aim of this study was to examine the impact of the COVID-19 pandemic on smoking in PWH. A survey was administered to participants in two smoking cessation trials in the United States. Mean cigarettes per day was 13.9 (SD 8.6), and participants reported they had smoked on average for 30.93 years (SD 10.4). More than half (55.7%) of participants (N = 140) reported not changing their smoking during the pandemic, while 15% reported decreasing, and 25% reported increasing their smoking. In bivariate analyses, worrying about food due to lack of money (χ2 = 9.13, df 2, p = 0.01) and greater Covid-related worry (rs = 0.19, p = 0.02) were significantly associated with increased smoking. Qualitative research may be needed to more clearly elucidate factors related to smoking behaviors among PWH.
Collapse
Affiliation(s)
- Patricia A Cioe
- Center for Alcohol & Addiction Studies, Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, RI, USA.
| | - Robert Schnoll
- Department of Psychiatry and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Bettina B Hoeppner
- Department of Psychiatry, Recovery Research Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Robert Gross
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA
- Division of Infectious Diseases, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Brian L Hitsman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Frank T Leone
- Pulmonary, Allergy, & Critical Care Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca Ashare
- Department of Psychiatry and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychology, State University of New York at Buffalo, Buffalo, NY, USA
| | - Roger Vilardaga
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Karen Tashima
- Division of Infectious Diseases, Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Megan Pinkston
- Division of Infectious Diseases, Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Christopher W Kahler
- Center for Alcohol & Addiction Studies, Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, RI, USA
| |
Collapse
|
2
|
Schnall R, Trujillo P, Alvarez G, Michaels CL, Brin M, Huang MC, Chen H, Xu W, Cioe PA. Theoretically Guided Iterative Design of the Sense2Quit App for Tobacco Cessation in Persons Living with HIV. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4219. [PMID: 36901229 PMCID: PMC10001855 DOI: 10.3390/ijerph20054219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/19/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
The use of mobile health (mHealth technology) can be an effective intervention when considering chronic illnesses. Qualitative research methods were used to identify specific content and features for a mobile app for smoking cessation amongst people living with HIV (PWH). We conducted five focus group sessions followed by two Design Sessions with PWH who were or are currently chronic cigarette smokers. The first five groups focused on the perceived barriers and facilitators to smoking cessation amongst PWH. The two Design Sessions leveraged the findings from the focus group sessions and were used to determine the optimal features and user interface of a mobile app to support smoking cessation amongst PWH. Thematic analysis was conducted using the Health Belief Model and Fogg's Functional Triad. Seven themes emerged from our focus group sessions: history of smoking, triggers, consequences of quitting smoking, motivation to quit, messages to help quit, quitting strategies, and mental health-related challenges. Functional details of the app were identified during the Design Sessions and used to build a functional prototype.
Collapse
Affiliation(s)
- Rebecca Schnall
- School of Nursing, Columbia University, New York, NY 10032, USA
- School of Public Health, Columbia University Mailman, New York, NY 10032, USA
| | - Paul Trujillo
- School of Nursing, Columbia University, New York, NY 10032, USA
| | | | | | - Maeve Brin
- School of Nursing, Columbia University, New York, NY 10032, USA
| | - Ming-Chun Huang
- School of Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Huan Chen
- School of Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Wenyao Xu
- Department of Computer Science & Engineering, University at Buffalo, The State University of New York, Buffalo, NY 14260, USA
| | - Patricia A. Cioe
- School of Public Health, Brown University, Providence, RI 02903, USA
| |
Collapse
|
3
|
Bien-Gund CH, Choi GH, Mashas A, Shaw PA, Miller M, Gross R, Brady KA. Persistent Disparities in Smoking Rates Among PLWH Compared to the General Population in Philadelphia, 2009-2014. AIDS Behav 2021; 25:148-153. [PMID: 32591983 DOI: 10.1007/s10461-020-02952-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Despite reductions in smoking rates in the general population, little is known about recent smoking trends among people living with HIV (PLWH). We compared the risk for smoking and temporal trends in smoking among PLWH and the general population in the Philadelphia metropolitan area between 2009 and 2014. We used weighted logistic regression to assess the relation between HIV and smoking, and examined temporal smoking trends. The adjusted odds ratio (OR) for smoking comparing PLWH to the general population was 1.80 (95% CI 1.55-2.09) after adjusting for socio-economic, demographic, and mental health diagnosis variables. Smoking prevalence decreased in both the PLWH and general populations during the study period, and we did not observe a significant difference in rates of decline between groups (P = 0.54). Despite overall progress in smoking cessation, a disparity persisted in smoking rates between PLWH and the general population, with and without adjustment for socio-economic, demographic, and mental health variables. Further research is needed to understand the mechanisms linking HIV and tobacco use in order to inform public health efforts to reduce smoking among PLWH.
Collapse
Affiliation(s)
- Cedric H Bien-Gund
- Division of Infectious Diseases, Department of Medicine, University of Pennsylvania Perelman School of Medicine, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
| | - Grace H Choi
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Philadelphia Department of Public Health, AIDS Activities Coordinating Office, Philadelphia, PA, USA
| | - Antonios Mashas
- Philadelphia Department of Public Health, AIDS Activities Coordinating Office, Philadelphia, PA, USA
| | - Pamela A Shaw
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Melissa Miller
- Philadelphia Department of Public Health, AIDS Activities Coordinating Office, Philadelphia, PA, USA
| | - Robert Gross
- Division of Infectious Diseases, Department of Medicine, University of Pennsylvania Perelman School of Medicine, 3400 Spruce Street, Philadelphia, PA, 19104, USA
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | - Kathleen A Brady
- Philadelphia Department of Public Health, AIDS Activities Coordinating Office, Philadelphia, PA, USA
| |
Collapse
|