The association of weight gain and smoking outcomes in a sample of HIV-positive smokers
The prevalence of cigarette smoking among people living with HIV/AIDS is extremely high, approximately 50-70%. This is significantly higher than the rate of smoking in the general population which is approximately 19%. In the general population, weight gain proceeding smoking cessation has been associated with higher rates of relapse. However, this association has not been studied among people living with HIV/AIDS. A secondary data analysis of HIV-infected smokers in a smoking cessation study was used to look at the association of body mass index (BMI) change after a quit attempt and smoking outcomes at 3-month follow-up. Change in BMI was measured from the time of baseline assessment to 3-month follow-up using physical exam data from clinic visits. Participants were classified as having an increase in BMI or a decrease in BMI from baseline to 3-month follow-up. Smoking outcomes at 3-month follow-up included 7-day abstinence and longest length of abstinence, measured in days. The association between BMI and smoking outcomes was analyzed using stratified analyses, logistic and linear regression models. Results from stratified analyses showed that BMI change was not significantly associated with reporting 7-day abstinence at 3-month follow-up. Participants with an increase in BMI reported a higher mean longest length of abstinence as compared to participants with a decrease or no change in BMI, but this difference was not statistically significant. After stratifying by treatment group, a stronger association, although not statistically significant, was observed between increase in BMI and 7-day smoking abstinence in the standard of care group. After stratifying by gender, there was not a significant association between increase in BMI and 7-day abstinence. The odds ratio was similar between males and females indicating that the association is not modified by gender. Results from a logistic regression of predictors of 7-day abstinence showed no association between an increase in BMI and 7-day abstinence. Results from a linear regression of predictors of longest length of abstinence showed that participants with an increase in BMI reported a longest length of abstinence that was approximately 2.63 days longer than that of participants with a decrease or no change in BMI. However, this was not statistically significant. Further research is needed to look at the association of change in BMI and smoking outcomes at 6 and 12 months post-quit date. A better understanding of the predictors of relapse for HIV-infected smokers will allow us to more effectively tailor interventions. Tailored interventions have the potential to reduce morbidity and mortality among HIV-infected smokers.
Buchberg, Meredith, "The association of weight gain and smoking outcomes in a sample of HIV-positive smokers" (2013). Texas Medical Center Dissertations (via ProQuest). AAI1549930.