Patterns and Correlates of Multiple tobacco Product use Among people With HIV in India.

Introduction

Multiple tobacco product (MTP) use may intensify nicotine dependence and reduce the chances of quitting success. Characterizing MTP use in people with HIV (PWH) in low- and middle-income countries (LMICs) is needed to guide cessation approaches in this group. This study aimed to identify patterns and correlates of MTP use among PWH in a single clinic.

Methods

This study was conducted among PWH at a clinic in Chennai, India. Participants completed an in-person survey providing information on tobacco use, demographics, and cessation-related factors. This analysis focused on PWH who reported current tobacco use. We used Fisher's exact test (categorical variables) and the Wilcoxon rank-sum test (continuous variables) to assess statistical differences in demographics and cessation-related factors between PWH who used single vs multiple tobacco products.

Results

Of 154 PWH adults surveyed, 58 (37.7%) reported current tobacco use. Most PWH currently using tobacco were male (n = 49/58, 84%), with a median age of 21 years (IQR: 10). Forty-six percent (n = 27/58; 95% CI: 33% - 60%) reported MTP use, combining three products (IQR: 3) on average. Those who used multiple products were more likely to have a higher education level (n = 12/27, 44%; 95% CI: 25% - 65%) compared to those who used a single product (n = 2/16, 12%; 95% CI: 1% - 38%) (P-value = 0.03). A lower proportion of participants who reported MTP use were unemployed (n = 1/27, 97%; 95% CI: 0% - 19%) compared to those who used a single product (n = 5/16, 31%; 95% CI: 11% - 59%) (P-value = 0.04). All other factors, including gender, primary language, marital status, and cessation-related factors, were comparable between PWH who used a single tobacco product and those who used multiple products.

Conclusion

Among PWH who currently smoke, almost half use tobacco combined multiple products. MTP use in PWH was linked to higher education levels and employment in this single clinical setting.