Perceived barriers to smoking cessation and perceptions of electronic cigarettes among persons living with HIV

ABSTRACT

Smoking is more prevalent in persons living with HIV than the general population and is linked to increased morbidity and mortality. Some have suggested that based on current knowledge of harms and benefits, it may be feasible to advise smokers who are unable or unwilling to quit to switch to electronic cigarettes (ECs) as a less harmful alternative. We conducted 25 qualitative interviews with HIV-positive current or former smokers to explore perceived barriers to smoking cessation and perceptions of ECs. A high level of nicotine dependence, smoking as a form of stress management, motivational factors (including lack of readiness, low self-efficacy, ambivalence toward quitting), and having a social network of smokers were identified as cessation barriers. Low knowledge of ECs and uncertainty about EC safety and efficacy were barriers to EC uptake. However, current smokers indicated a willingness to try ECs. This study provides evidence that HIV-positive smokers face significant individual and environmental barriers to cessation. ECs may have potential as a harm reduction strategy in this population; however, there is a significant need for education regarding use and relative safety.

KEYWORDS:

• HIV
• smoking
• electronic cigarettes
• qualitative research

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the National Institutes of Health under grant numbers [grant number K23NR014951] (PAC), and [grant number K24 HD062645] (KMG). This work was facilitated by the Providence/Boston Center for AIDS Research [grant number P30AI042853]. National Institute of Child Health and Human Development; National Institute of Nursing Research