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Tobacco use and nicotine dependence among HIV-infected and uninfected injection drug users.
Addict Behav. 2011 Jan-Feb; 36(1-2):61-7.AB

Abstract

INTRODUCTION

Urban U.S. populations are burdened by intersecting epidemics of HIV infection, injection drug use, and cigarette smoking. Given the substantial morbidity attributable to tobacco in these populations, we characterized smoking behaviors, nicotine addiction, and tobacco exposure among HIV-infected and HIV-uninfected injection drug users (IDUs) in Baltimore, Maryland.

METHODS

Smoking behaviors among participants in the ALIVE Study were assessed using interviewer-administered questionnaires. Smoking history and nicotine dependence (Fagerstrom Index scores) were compared by HIV and drug injecting status. Serum cotinine (a nicotine metabolite) was measured for a sample of participants by enzyme immunoassay.

RESULTS

Among 1052 participants (29.7% HIV-infected, 39.8% active injectors), 85.2% were current smokers and 9.3% were former smokers. Smoking prevalence, age at smoking initiation, and cumulative tobacco exposure were similar by HIV status. Median Fagerstrom scores of 4 for HIV-infected and HIV-uninfected smokers indicated moderate nicotine dependence. Daily cigarette consumption was identical by HIV status (median 10 cigarettes), although HIV-infected participants were less likely to smoke 1+ pack daily compared to HIV-uninfected participants (18.0% vs. 26.9%, p=0.001). Compared to former injectors, active injectors had higher smoking prevalence (90.5% vs. 81.7%, p=0.0001), greater daily cigarette consumption (30.7% vs. 19.6% smoked 1+ pack daily, p=0.0001), and slightly higher Fagerstrom scores (median 5 vs. 4). Cotinine levels paralleled self-reported cigarette consumption.

DISCUSSION

Tobacco use is extremely common among inner-city IDUs. Smoking behavior and nicotine dependence did not materially differ by HIV status but were associated with active drug injection. Cessation efforts should target the dual dependence of cigarettes and drugs experienced among this population.

Authors+Show Affiliations

Department of Epidemiology, School of Public Health, Johns Hopkins University, Baltimore, MD 21205, United States. mariahm111@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural

Language

eng

PubMed ID

20875704

Citation

Marshall, Mariah M., et al. "Tobacco Use and Nicotine Dependence Among HIV-infected and Uninfected Injection Drug Users." Addictive Behaviors, vol. 36, no. 1-2, 2011, pp. 61-7.
Marshall MM, Kirk GD, Caporaso NE, et al. Tobacco use and nicotine dependence among HIV-infected and uninfected injection drug users. Addict Behav. 2011;36(1-2):61-7.
Marshall, M. M., Kirk, G. D., Caporaso, N. E., McCormack, M. C., Merlo, C. A., Hague, J. C., Mehta, S. H., & Engels, E. A. (2011). Tobacco use and nicotine dependence among HIV-infected and uninfected injection drug users. Addictive Behaviors, 36(1-2), 61-7. https://doi.org/10.1016/j.addbeh.2010.08.022
Marshall MM, et al. Tobacco Use and Nicotine Dependence Among HIV-infected and Uninfected Injection Drug Users. Addict Behav. 2011 Jan-Feb;36(1-2):61-7. PubMed PMID: 20875704.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tobacco use and nicotine dependence among HIV-infected and uninfected injection drug users. AU - Marshall,Mariah M, AU - Kirk,Gregory D, AU - Caporaso,Neil E, AU - McCormack,Meredith C, AU - Merlo,Christian A, AU - Hague,John C, AU - Mehta,Shruti H, AU - Engels,Eric A, Y1 - 2010/09/26/ PY - 2010/03/08/received PY - 2010/08/05/revised PY - 2010/08/23/accepted PY - 2010/9/30/entrez PY - 2010/9/30/pubmed PY - 2011/5/12/medline SP - 61 EP - 7 JF - Addictive behaviors JO - Addict Behav VL - 36 IS - 1-2 N2 - INTRODUCTION: Urban U.S. populations are burdened by intersecting epidemics of HIV infection, injection drug use, and cigarette smoking. Given the substantial morbidity attributable to tobacco in these populations, we characterized smoking behaviors, nicotine addiction, and tobacco exposure among HIV-infected and HIV-uninfected injection drug users (IDUs) in Baltimore, Maryland. METHODS: Smoking behaviors among participants in the ALIVE Study were assessed using interviewer-administered questionnaires. Smoking history and nicotine dependence (Fagerstrom Index scores) were compared by HIV and drug injecting status. Serum cotinine (a nicotine metabolite) was measured for a sample of participants by enzyme immunoassay. RESULTS: Among 1052 participants (29.7% HIV-infected, 39.8% active injectors), 85.2% were current smokers and 9.3% were former smokers. Smoking prevalence, age at smoking initiation, and cumulative tobacco exposure were similar by HIV status. Median Fagerstrom scores of 4 for HIV-infected and HIV-uninfected smokers indicated moderate nicotine dependence. Daily cigarette consumption was identical by HIV status (median 10 cigarettes), although HIV-infected participants were less likely to smoke 1+ pack daily compared to HIV-uninfected participants (18.0% vs. 26.9%, p=0.001). Compared to former injectors, active injectors had higher smoking prevalence (90.5% vs. 81.7%, p=0.0001), greater daily cigarette consumption (30.7% vs. 19.6% smoked 1+ pack daily, p=0.0001), and slightly higher Fagerstrom scores (median 5 vs. 4). Cotinine levels paralleled self-reported cigarette consumption. DISCUSSION: Tobacco use is extremely common among inner-city IDUs. Smoking behavior and nicotine dependence did not materially differ by HIV status but were associated with active drug injection. Cessation efforts should target the dual dependence of cigarettes and drugs experienced among this population. SN - 1873-6327 UR - https://www.unboundmedicine.com/medline/citation/20875704/Tobacco_use_and_nicotine_dependence_among_HIV_infected_and_uninfected_injection_drug_users_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0306-4603(10)00258-3 DB - PRIME DP - Unbound Medicine ER -