Knowledge, Attitude, and Behavior Towards Cigarette Smoking in HIV-Positive Populations: An In- Depth Qualitative Study

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Advisor: JD Plumb, MD Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia


It is a known fact that cigarette smoking increases the risk of developing chronic health problems. The National Center for Health Statistics estimates that approximately 25.9 million men (23.9 percent) and 20.7 million women (18.1 percent) are smokers in the US. However, many studies show that these percentages are not mirrored in HIV positive populations where smoking prevalence ranges from 50%-70%. As the number of people living with HIV/AIDS (PLWHA) continues to rise, cigarette smoking is becoming one of the leading contributors and causes of chronic illness among PLWHA with further implications in disease management and healthcare costs. Current literature shows little on efforts around smoking and PLWHA. This qualitative study identifies the knowledge, attitude, and behaviors towards cigarette smoking, describes the problem, conducts a needs assessment, and offers suggestions for effective smoking cessation intervention. To explore this population and its needs, students from Thomas Jefferson University conducted two focus groups among PLWHA enrolled in HIV/AIDS management courses at a local AIDS service organization. Through content analysis we were able to discover that the population has a strong interest in quitting smoking with some successful efforts and view smoking as detrimental to overall health. However, participants also believed that the locus of control over their cigarette addiction lay outside of the individual. Although aware of smoking consequences on health, participants showed lack of knowledge with the level and severity of cigarette smoking as compared to non- positive populations. Also shown was the lack of proper and effective smoking cessation counseling with their physicians. Participants also expressed needs different from non-positive populations and dissatisfaction with general smoking cessation programs. The study suggests that the needs of this population can be met with a smoking cessation program geared specifically to PLWHA and the need to for HIV care physicians to improve cessation counseling efforts.