Correlates of cigarette quit intentions and attempts in Nigerian adults living with HIV

Abstract Significance People living with HIV (PLWH) have higher rates of tobacco use than the general population, which increases their risk of illness and death from non-AIDS-related diseases. This study assessed intention to quit (ITQ) and attempts to quit (ATQ) cigarettes among PLWH in Nigeria. Methods A cross-sectional study was conducted among 761 PLWH receiving care at five Anti-Retroviral Therapy centers in Lagos, Nigeria. Independent measures included demographic, health-related information, current (past 30 days) waterpipe tobacco smoking, e-cigarette, marijuana smoking, alcohol use, cigarette absolute harm perception, and nicotine dependence. Outcome measures included the past 6-month ITQ and the past-year ATQ for cigarette smoking. Multivariable regression analyses explored factors associated with ITQ and ATQ. Results Overall, 53.9% of the participants were current cigarette smokers, which was significantly more common among males than females (83.7% vs. 41.3%), unmarried individuals than married (56.6% vs. 24.8%), and those employed than unemployed (72.4% vs. 55.8%). Despite 88% of current smokers exhibiting high nicotine dependence, only 11.9% had past 6-month ITQ, and 6.6% past-year ATQ. Low dependence (adjusted odds ratios aOR = 2.33, 95% CI 1.22–4.45), comorbidities (aOR 6.86, 95% CI 1.26–17.31), no current alcohol use (aOR 8.23, 95% CI 1.67–40.46), no current waterpipe tobacco use (aOR 2.26, 95% CI 1.26–4.05), and no current marijuana use (aOR 2.55, 95% CI 1.06–6.19) were significantly associated with past 6-month ITQ; while no current alcohol use (aOR 3.82, 95% CI 1.67–8.70), no current waterpipe tobacco use (aOR 8.09, 95% CI 2.38–27.48), and no current marijuana use (aOR 6.35, 95% CI 2.59–15.55) were significantly related to past-year ATQ. Conclusions Among PLWH, ITQ and ATQ were not common despite high dependence levels, with lower dependence and absence of concurrent substance use being key factors associated with quit intentions and attempts. Future studies need to evaluate tailored smoking cessation interventions for PLWH that address polysubstance use patterns.