Smoking motivations and quitting motivations among HIV-infected smokers.

Background: The aim of this study was to examine smoking motivation and motivation to quit, and determinants of these motivations among HIV-infected cigarette smokers.
Methods: We conducted a 1-day cross-sectional survey on cigarette smoking in a representative sample of HIV-infected outpatients of French hospitals. A cluster analysis was used to characterize respondents' smoking motivation. A logistic regression was performed to study the factors associated with motivation to quit, including the clusters describing smoking motives.
Results: We found four clusters of smoking motivation. These included intellectual/emotional support (22% of respondents), automatic/stress relief (22%; characterized by heavy smoking and strong dependency); weight control (29%; characterized by frequent symptoms of fat accumulation because of antiretroviral therapy) and pleasure/conviviality (27%; corresponding to 'lighter' smokers). In the logistic regression model, among other significant covariates (cigarette consumption level, tobacco dependence and perceived risk of developing a smoking-related disease), the automatic/stress relief cluster was negatively correlated to the motivation to quit (odds ratio 0.39), whereas the weight control cluster was strongly associated to this motivation (odds ratio 2.87).
Conclusions: The diversity of HIV-infected smokers' profiles suggests that different types of anti-tobacco measures should be implemented in this population, such as information campaigns on specific risks incurred by HIV-infected smokers, non-specific and comprehensive measures for those for whom smoking is combined with other difficulties, and alternative therapeutic solutions for those who smoke to deal with lipodystrophy.