Estimates of prevalence, time-trend, and association of smoking in adults living with HIV, HBV, and HCV (NHANES 1999-2018)

Abstract

Although the smoking rate of human immunodeficiency virus (HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV) infected people was much higher than that of the general population, smoking cessation interventions have long been ineffective. We aimed to examine the estimates of prevalence, time-trend, and association of smoking among people living with HIV, HBV, or HCV. This cohort was composed of 32,115 individuals from the NHANES database (1999-2018) and they were collected in the US. The time trend analysis of smoking and quitting rates was conducted using different years of survey follow-up and different infected groups. Multivariable logistic regression analysis was used to identify the risk factors related to smoking behavior of these infected people. Compared to non-infected smokers, infected smokers were more likely to be older (aged 30-39, OR = 9.92, CI 6.07-16.21; aged 40-49,OR = 3.51, CI 2.49-4.94), males (1.99, 1.54-2.55), lower education and economic level (1.78, 1.39-2.29; 2.05, 1.59-2.65), unemployed (1.63, 1.21-2.20), suffering depression (1.35, 1.05-1.72), and drug users (7.65, 5.04-11.59). Taken together, our study showed that these complex psychosocial characteristics and unhealthy behavioral factors might be major independent risk factors for increasing smoking rate and decreasing smoking cessation rate among these infected people.

Figure 1

Study flow chart, NHANES 1999–2018.

Figure 2

Trend analysis of change in the percentage of current smoking among people living with HIV|HBV|HCV compared to people without HIV|HBV|HCV (NHANES; 10 survey cycles, 1999–2018). (a) The percentage of current smoking between people living with HIV and without HIV; (b) the percentage of current smoking between people living with HBV and without HBV; (c) the percentage of current smoking between people living with HCV and without HCV; (d) the percentage of current smoking between people living with HIV|HBV|HCV and without HIV&HBV&HCV.

Figure 3

Trend analysis of change in the percentage of quit smoking among people living with HIV|HBV|HCV compared to people without HIV|HBV|HCV (NHANES; 10 survey cycles, 1999–2018). (a) The percentage of quit smoking between people living with HIV and without HIV; (b) the percentage of quit smoking between people living with HBV and without HBV; (c) the percentage of quit smoking between people living with HCV and without HCV; (d) the percentage of quit smoking between people living with HIV|HBV|HCV and without HIV&HBV&HCV.