Relationship of HIV stigma and smoking stigma to cigarette dependence and quit motivation among adults with HIV

People with HIV (PWH) smoke cigarettes at a prevalence nearly two times higher than the United States (US) population. Stigma may contribute to persistent smoking among PWH, yet the interaction of HIV- and smoking-related stigma on smoking behaviors remains unexplored. This secondary analysis of self-report survey data included 81 adults with HIV and current cigarette smoking recruited from the Bronx, New York (US). Sequential logistic regression models examined main and interaction effects of HIV stigma and smoking stigma on cigarette dependence and motivation to quit smoking. Greater smoking stigma was associated with higher cigarette dependence, with and without adjusting for age (ps = 0.01). Participants reporting higher smoking stigma had nearly four times greater odds (95% CI: 1.43–10.44) of higher cigarette dependence. Follow-up analyses of smoking stigma subscales found that the Felt Smoking Stigma subscale was associated with higher cigarette dependence (p = 0.04). HIV stigma and the HIV and smoking stigma interaction were not associated with cigarette dependence. Neither stigma was associated with motivation to quit smoking. Smoking stigma, particularly perceiving judgement from others related to smoking, was associated with greater cigarette dependence among PWH. Smoking-related stigma may be an important psycho-behavioral target for cessation interventions for PWH who smoke.