Prevalence of Tobacco Smoking and Stages of Behavior Change in People Living with HIV: A Descriptive Cross-Sectional Study in Indonesia
Keywords:
Indonesia, HIV, Smoking, Smoking cessation, Stage of change, Tobacco smoking, Transtheoretical ModelAbstract
The interaction of smoking and HIV has a substantially negative impact on multiple comorbidities, disease prognosis, and impaired adherence to HIV drugs. The health benefits of smoking cessation are well documented among HIV-positive individuals. However, there are no clinical practice guidelines to guide tobacco smoking cessation treatment in people living with HIV. Addressing the current stage of change for smokers may help provide appropriate and effective advice on smoking cessation. This cross-sectional study explored the prevalence of smoking and the stage of change in people living with HIV at an AIDS non-governmental organization in West Java, Indonesia. Convenience sampling was used to recruit 150 participants aged over 20 years old. Data were collected on demographic and clinical information, smoking status, willingness to quit smoking and using the instrument of stage of change based on the Transtheoretical Model.
Results indicated that most respondents were males, 30 to 40 years old. More than half (53%) were currently smoking more than ten cigarettes per day (55%). Among smokers, 80% were willing to quit smoking, and more than half were in the preparation stage. The majority of respondents (65%) had never heard about a smoking cessation program, and 91% had never joined this program. We concluded that more than half of people living with HIV were currently smoking, and most smokers were only at the pre-contemplation stage. Systematic screening for smoking during routine HIV care using the Transtheoretical Model “stage of change” model may help to reduce the heavy burden of smoking and smoking-related morbidity and mortality within HIV populations. In addition, smoking cessation training for nurses or case managers who care for people living with HIV is required to help, assist, and support HIV smokers in quitting.
References
1. McIntosh EC, Tureson K, Rotblatt LJ, Singer EJ, Thames AD. HIV, vascular risk factors, and cognition in the combination antiretroviral therapy era: a systematic review and metaanalysis. J Int Neuropsychol Soc. 2021 Apr;27(4):365-81. DOI: 10.1017/S1355617720001022.
2. Wieland, U., Hellmich, M., Wetendorf, J., Potthoff, A., Hofler, D., Swoboda, J., Kreuter, A. Smoking and anal high-risk human papillomavirus DNA loads in HIV-positive men who have sex with men. Int J Med Microbiol. 2015; 305(7): 689-96.
DOI:10.1016/j.ijmm.2015.08.019.
3. Lindayani L, Yeh C-Y, Ko W-C, Ko N-Y. High smoking prevalence among HIV-positive individuals: a systematic review and meta-analysis. J Subst Abuse. 2019; 25(1):1-10. DOI: 10.1080/14659891.2019. 1652364.
4. Hile SJ, Feldman MB, Alexy ER, Irvine MK. Recent tobacco smoking is associated with poor hiv medical outcomes among hiv-infected individuals in New York. AIDS Behav. 2016;20(8):1722-29. doi:10.1007/s10461- 015-1273-x.
5. National Statistics Center. (2020). Tobacco report in 2020. [Internet] 20 Mar 20 [cited 30 June 2021]. Available from: https://www.bps.go.id/indicator/30/1435/1/persentase- merokok-pada-penduduk-umur-15-tahunmenurut-provinsi.html (in Bahasa Indonesia)
6. Costiniuk CT, Brunet L, Rollet-Kurhajec KC, et al. Tobacco smoking is not associated with accelerated liver disease in human immunodeficiency virus-hepatitis c coinfection: a longitudinal cohort analysis. Open Forum Infect Dis. 2016;3(2):ofw050. DOI:10.1093/ofid/ofw050.
7. Ministry of Health of Republic Indonesia. (2020). Cases of HIV/AIDS in Indonesia Reported thru’ March 2020. [Internet] 20 Mar 20 [cited 30 June 2021]. Available from: https://pusdatin.kemkes.go.id/resources/download/ pusdatin/infodatin/infodatin-2020-HIV.pdf (in Bahasa Indonesia)
8. Benard A, Bonnet F, Tessier JF, et al. Tobacco addiction and HIV infection: toward the implementation of cessation programs ANRS CO3 Aquitaine Cohort. AIDS Patient Care STDS. 2007;21(7):458-68. doi:10.1089/apc.2006.0142.
9. Manuel JK, Lum PJ, Hengl NS, Sorensen JL. Smoking cessation interventions with female smokers living with HIV/AIDS: a randomized pilot study of motivational interviewing. AIDS Care. 2013; 25(7): 820-7. doi:10.1080/09540121.2012.733331.
10. Petoumenos K, Worm S, Reiss P, de Wit S, D'Arminio Monforte A, Sabin C, Friis-Møller N, Weber R, Mercie P, Pradier C, El-Sadr W, Kirk O, Lundgren J, Law M. Rates of cardiovascular disease following smoking cessation in patients with HIV infection: results from the D:A:D study. HIV Med. 2011;12(7):412-21. doi: 10.1111/j.1468-1293.2010.00901.x.
11. Heseltine T, Murray S, Ortega-Martorell S, Olier I, Lip GYH, Khoo S. Associations of hepatosteatosis with cardiovascular disease in HIV positive and HIV negative patients: the liverpool HIV-heart project. J Acquir Immune Defic Syndr. 2021 May 8. DOI: 10.1097/QAI.0000000000002721.
12. Chichester NE, Kundu S, Freiberg MS, Koethe JR, Butt AA, Crystal S, So-Armah KA, Cook RL, Braithwaite RS, Justice AC, Fiellin DA, Khan M, Bryant KJ, Gaither JR, Barve SS, Crothers K, Bedimo RJ, Warner A, Tindle HA, Veterans Aging Cohort Study. Association of syndemic unhealthy alcohol use, smoking, and depressive symptoms on incident cardiovascular disease among veterans with and without HIV-infection. AIDS Behav. 2021 Jun 8. DOI: 10.1007/s10461-021-03327-4.
13. Cui Q, Carruthers S, McIvor A, Small F, Thabane L, Smieja M. Effect of smoking on lung function, respiratory symptoms and respiratory diseases amongst HIV-positive subjects: a crosssectional study. AIDS Res Ther. 2010;7:6. DOI:10. 1186/1742-6405-7-6.
14. Price SN, Studts JL, Hamann HA. Tobacco use assessment and treatment in cancer patients: a scoping review of oncology care clinician adherence to clinical practice guidelines in the U.S. Oncologist. 2019;24(2):229-38. doi:10.1634/theoncologist.2018-0246.
15. Chew D, Steinberg MB, Thomas P, Swaminathan S, & Hodder SL. Evaluation of a smoking cessation program for HIV infected individuals in an urban HIV clinic: challenges and lessons learned. AIDS Res Treat. 2014;237834. DOI:10.1155/2014/237834.
16. Vijayaraghavan M, Penko J, Vittinghoff E, Bangsberg DR, Miaskowski C, Kushel MB. Smoking behaviors in a community-based cohort of HIV-infected indigent adults. AIDS Behaviour. 2014;18(3):535-43. doi:10.1007/s10461-013-0576-z.
17. Yasin SM, Retneswari M, Moy FM, Taib KM, Isahak M, & Koh D. Testing the Transtheoretical Model in predicting smoking relapse among Malaysian adult smokers receiving assistance in quitting. Asian Pac J Cancer Prev. 2013;14(4):2317-23. DOI: 10.7314/apjcp.2013. 14.4.2317.
18. Prochaska JO, Velicer WF. The Transtheoretical model of health behavior change. Am J Health Promot. 1997;12(1):38-48. DOI: 10.4278/0890-1171-12.1.38.
19. Campbell S, Bohanna I, Swinbourne A, Cadet-James Y, McKeown D, McDermott R. Stages of change, smoking behaviour and readiness to quit in a large sample of indigenous Australians living in eight remote north Queensland communities. Int J Environ Res Public Health. 2013; 10(4):1562-71. DOI:10.3390/ijerph10041562.
20. Onchonga D, Khatatbeh H, Thuranira M, Lennox K, Venkatesh MBR. Assessing the usability of a willingness to quit smoking questionnaire in a sample of active tobacco smokers: A qualitative study. J Addict Dis. 2021;39(1):3-10. doi:10.1080/10550887.2020.1800891.
21. Fjalldal SB, Janson C, Benediktsdóttir B, Gudmundsson G, Burney P, Buist AS, Vollmer WM, Gíslason T. Smoking, stages of change and decisional balance in Iceland and Sweden. Clin Respir J. 2011;5(2):76-83. DOI: 10.1111/j.1752-699X.2010.00201.x.
22. World Health Organization. WHO report on the global tobacco epidemic 2019: Geneva [cited 30 June 2021]. Available from:https://www.who.int/teams/health-promotion/tobaccocontrol/who-report-on-the-global-tobacco-epidemic-2019
23. Floridia M, Ravizza M, Masuelli G, et al. Prevalence, correlates and outcomes of smoking in pregnant women with HIV: a national observational study in Italy. Subst Use Misuse. 2020;55(7):1165-72. doi:10.1080/10826084.2020.1729204.
24. Modo R, Frazier EL, Dube SR, Mattson CL, Sutton MY, Brooks J T, Skarbinski J. 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(5):335-44. DOI:10.7326/ M14-0954.
25. Braith H, Grabovac I, Schalk H, Degen O, Dorner TE. Prevalence and correlates of smoking and readiness to quit smoking in people living with HIV in Austria and Germany. PLoS One. 2016; 11(2):e0150553. DOI: 10.1371/journal.pone.0150553.
26. Elf JL, Variava E, Chon S, et al. Prevalence and correlates of smoking among people living with HIV in South Africa. Nicotine Tob Res. 2018;20(9):1124-31. doi:10.1093/ntr/ntx145.
27. Nguyen NP, Tran BX, Hwang LY, Markham CM, Swartz MD, Phan HT, et al. Prevalence of cigarette smoking and associated factors in a large sample of HIV-positive patients receiving antiretroviral therapy in Vietnam. PLoS One. 2015; 10(2): e0118185. doi: 10.1371/journal.pone.0118185.
28. Braithwaite RS, Fang Y, Tate J, Mentor SM, Bryant KJ, Fiellin DA, Justice AC. Do alcohol misuse, smoking, and depression vary concordantly or sequentially? a longitudinal study of HIV-infected and matched uninfected veterans in care. AIDS Behav. 2016;20(3):566-72. DOI: 10.1007/s10461-015-1117-8.
29. Degen O, Arbter P, Hartmann P, et al. Smoking prevalence, readiness to quit and smoking cessation in HIV+ patients in Germany and Austria. J Int AIDS Soc. 2014;17(4 Suppl 3):19729. 2014 Nov 2. doi:10.7448/IAS.17.4.19729.
30. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000 Dec 15;25(24):3186-91. doi: 10.1097/00007632-200012150-00014.
31. Lim KH, Ghazali SM, Lim HL, et al. Smoking susceptibility among non-smoking school-going adolescents in Malaysia: findings from a national school-based survey. BMJ Open. 2019;9(10):e031164. Published 2019 Oct 28. doi:10. 1136/bmjopen-2019-031164.
32. Stanton AM, Lee JS, Wirtz MR, Andersen LS, Joska J, Safren SA, van Zyl-Smit R, O'Cleirigh C. Tobacco use and health-related quality of life among individuals with depression who are receiving treatment for HIV in Cape Town, South Africa. Int J Behav Med. 2021 Jan 28. doi:10.1007/s12529-020-09951-z.
2. Wieland, U., Hellmich, M., Wetendorf, J., Potthoff, A., Hofler, D., Swoboda, J., Kreuter, A. Smoking and anal high-risk human papillomavirus DNA loads in HIV-positive men who have sex with men. Int J Med Microbiol. 2015; 305(7): 689-96.
DOI:10.1016/j.ijmm.2015.08.019.
3. Lindayani L, Yeh C-Y, Ko W-C, Ko N-Y. High smoking prevalence among HIV-positive individuals: a systematic review and meta-analysis. J Subst Abuse. 2019; 25(1):1-10. DOI: 10.1080/14659891.2019. 1652364.
4. Hile SJ, Feldman MB, Alexy ER, Irvine MK. Recent tobacco smoking is associated with poor hiv medical outcomes among hiv-infected individuals in New York. AIDS Behav. 2016;20(8):1722-29. doi:10.1007/s10461- 015-1273-x.
5. National Statistics Center. (2020). Tobacco report in 2020. [Internet] 20 Mar 20 [cited 30 June 2021]. Available from: https://www.bps.go.id/indicator/30/1435/1/persentase- merokok-pada-penduduk-umur-15-tahunmenurut-provinsi.html (in Bahasa Indonesia)
6. Costiniuk CT, Brunet L, Rollet-Kurhajec KC, et al. Tobacco smoking is not associated with accelerated liver disease in human immunodeficiency virus-hepatitis c coinfection: a longitudinal cohort analysis. Open Forum Infect Dis. 2016;3(2):ofw050. DOI:10.1093/ofid/ofw050.
7. Ministry of Health of Republic Indonesia. (2020). Cases of HIV/AIDS in Indonesia Reported thru’ March 2020. [Internet] 20 Mar 20 [cited 30 June 2021]. Available from: https://pusdatin.kemkes.go.id/resources/download/ pusdatin/infodatin/infodatin-2020-HIV.pdf (in Bahasa Indonesia)
8. Benard A, Bonnet F, Tessier JF, et al. Tobacco addiction and HIV infection: toward the implementation of cessation programs ANRS CO3 Aquitaine Cohort. AIDS Patient Care STDS. 2007;21(7):458-68. doi:10.1089/apc.2006.0142.
9. Manuel JK, Lum PJ, Hengl NS, Sorensen JL. Smoking cessation interventions with female smokers living with HIV/AIDS: a randomized pilot study of motivational interviewing. AIDS Care. 2013; 25(7): 820-7. doi:10.1080/09540121.2012.733331.
10. Petoumenos K, Worm S, Reiss P, de Wit S, D'Arminio Monforte A, Sabin C, Friis-Møller N, Weber R, Mercie P, Pradier C, El-Sadr W, Kirk O, Lundgren J, Law M. Rates of cardiovascular disease following smoking cessation in patients with HIV infection: results from the D:A:D study. HIV Med. 2011;12(7):412-21. doi: 10.1111/j.1468-1293.2010.00901.x.
11. Heseltine T, Murray S, Ortega-Martorell S, Olier I, Lip GYH, Khoo S. Associations of hepatosteatosis with cardiovascular disease in HIV positive and HIV negative patients: the liverpool HIV-heart project. J Acquir Immune Defic Syndr. 2021 May 8. DOI: 10.1097/QAI.0000000000002721.
12. Chichester NE, Kundu S, Freiberg MS, Koethe JR, Butt AA, Crystal S, So-Armah KA, Cook RL, Braithwaite RS, Justice AC, Fiellin DA, Khan M, Bryant KJ, Gaither JR, Barve SS, Crothers K, Bedimo RJ, Warner A, Tindle HA, Veterans Aging Cohort Study. Association of syndemic unhealthy alcohol use, smoking, and depressive symptoms on incident cardiovascular disease among veterans with and without HIV-infection. AIDS Behav. 2021 Jun 8. DOI: 10.1007/s10461-021-03327-4.
13. Cui Q, Carruthers S, McIvor A, Small F, Thabane L, Smieja M. Effect of smoking on lung function, respiratory symptoms and respiratory diseases amongst HIV-positive subjects: a crosssectional study. AIDS Res Ther. 2010;7:6. DOI:10. 1186/1742-6405-7-6.
14. Price SN, Studts JL, Hamann HA. Tobacco use assessment and treatment in cancer patients: a scoping review of oncology care clinician adherence to clinical practice guidelines in the U.S. Oncologist. 2019;24(2):229-38. doi:10.1634/theoncologist.2018-0246.
15. Chew D, Steinberg MB, Thomas P, Swaminathan S, & Hodder SL. Evaluation of a smoking cessation program for HIV infected individuals in an urban HIV clinic: challenges and lessons learned. AIDS Res Treat. 2014;237834. DOI:10.1155/2014/237834.
16. Vijayaraghavan M, Penko J, Vittinghoff E, Bangsberg DR, Miaskowski C, Kushel MB. Smoking behaviors in a community-based cohort of HIV-infected indigent adults. AIDS Behaviour. 2014;18(3):535-43. doi:10.1007/s10461-013-0576-z.
17. Yasin SM, Retneswari M, Moy FM, Taib KM, Isahak M, & Koh D. Testing the Transtheoretical Model in predicting smoking relapse among Malaysian adult smokers receiving assistance in quitting. Asian Pac J Cancer Prev. 2013;14(4):2317-23. DOI: 10.7314/apjcp.2013. 14.4.2317.
18. Prochaska JO, Velicer WF. The Transtheoretical model of health behavior change. Am J Health Promot. 1997;12(1):38-48. DOI: 10.4278/0890-1171-12.1.38.
19. Campbell S, Bohanna I, Swinbourne A, Cadet-James Y, McKeown D, McDermott R. Stages of change, smoking behaviour and readiness to quit in a large sample of indigenous Australians living in eight remote north Queensland communities. Int J Environ Res Public Health. 2013; 10(4):1562-71. DOI:10.3390/ijerph10041562.
20. Onchonga D, Khatatbeh H, Thuranira M, Lennox K, Venkatesh MBR. Assessing the usability of a willingness to quit smoking questionnaire in a sample of active tobacco smokers: A qualitative study. J Addict Dis. 2021;39(1):3-10. doi:10.1080/10550887.2020.1800891.
21. Fjalldal SB, Janson C, Benediktsdóttir B, Gudmundsson G, Burney P, Buist AS, Vollmer WM, Gíslason T. Smoking, stages of change and decisional balance in Iceland and Sweden. Clin Respir J. 2011;5(2):76-83. DOI: 10.1111/j.1752-699X.2010.00201.x.
22. World Health Organization. WHO report on the global tobacco epidemic 2019: Geneva [cited 30 June 2021]. Available from:https://www.who.int/teams/health-promotion/tobaccocontrol/who-report-on-the-global-tobacco-epidemic-2019
23. Floridia M, Ravizza M, Masuelli G, et al. Prevalence, correlates and outcomes of smoking in pregnant women with HIV: a national observational study in Italy. Subst Use Misuse. 2020;55(7):1165-72. doi:10.1080/10826084.2020.1729204.
24. Modo R, Frazier EL, Dube SR, Mattson CL, Sutton MY, Brooks J T, Skarbinski J. 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(5):335-44. DOI:10.7326/ M14-0954.
25. Braith H, Grabovac I, Schalk H, Degen O, Dorner TE. Prevalence and correlates of smoking and readiness to quit smoking in people living with HIV in Austria and Germany. PLoS One. 2016; 11(2):e0150553. DOI: 10.1371/journal.pone.0150553.
26. Elf JL, Variava E, Chon S, et al. Prevalence and correlates of smoking among people living with HIV in South Africa. Nicotine Tob Res. 2018;20(9):1124-31. doi:10.1093/ntr/ntx145.
27. Nguyen NP, Tran BX, Hwang LY, Markham CM, Swartz MD, Phan HT, et al. Prevalence of cigarette smoking and associated factors in a large sample of HIV-positive patients receiving antiretroviral therapy in Vietnam. PLoS One. 2015; 10(2): e0118185. doi: 10.1371/journal.pone.0118185.
28. Braithwaite RS, Fang Y, Tate J, Mentor SM, Bryant KJ, Fiellin DA, Justice AC. Do alcohol misuse, smoking, and depression vary concordantly or sequentially? a longitudinal study of HIV-infected and matched uninfected veterans in care. AIDS Behav. 2016;20(3):566-72. DOI: 10.1007/s10461-015-1117-8.
29. Degen O, Arbter P, Hartmann P, et al. Smoking prevalence, readiness to quit and smoking cessation in HIV+ patients in Germany and Austria. J Int AIDS Soc. 2014;17(4 Suppl 3):19729. 2014 Nov 2. doi:10.7448/IAS.17.4.19729.
30. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000 Dec 15;25(24):3186-91. doi: 10.1097/00007632-200012150-00014.
31. Lim KH, Ghazali SM, Lim HL, et al. Smoking susceptibility among non-smoking school-going adolescents in Malaysia: findings from a national school-based survey. BMJ Open. 2019;9(10):e031164. Published 2019 Oct 28. doi:10. 1136/bmjopen-2019-031164.
32. Stanton AM, Lee JS, Wirtz MR, Andersen LS, Joska J, Safren SA, van Zyl-Smit R, O'Cleirigh C. Tobacco use and health-related quality of life among individuals with depression who are receiving treatment for HIV in Cape Town, South Africa. Int J Behav Med. 2021 Jan 28. doi:10.1007/s12529-020-09951-z.
Downloads
Published
2021-09-03
How to Cite
1.
Permana B, Legiana RD, Lindayani L. Prevalence of Tobacco Smoking and Stages of Behavior Change in People Living with HIV: A Descriptive Cross-Sectional Study in Indonesia. PRIJNR [Internet]. 2021 Sep. 3 [cited 2024 Nov. 5];25(4):666-7. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/253371
Issue
Section
Original paper
License
Copyright: The Pacific Rim International Journal of Nursing Research, Thailand Nursing & Midwifery Council has exclusive rights to publish, reproduce and distribute the manuscript and all contents therein.
.png)
