Evidence map›Paper›PMID 40658694›Full record

ArticlePloS one2025

Tobacco smoking and smokeless tobacco use among people living with HIV in Zambia: Findings from a 2023 National NCD/HIV Survey.

Cosmas Zyambo, Paul Somwe, Chomba Mandyata, Mwiche Musukuma, Phoebe Bwembya, Henry Phiri, Malizgani P Chavula, Hikabasa Halwindi, Joseph Zulu, Wilbroad Mutale

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In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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0cells of the map it votes in
3citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Cosmas ZyamboDepartment of Community and Family Medicine, School of Public Health, University of Zambia.ORCID https://orcid.org/0000-0003-1913-3367
Paul SomweCentre for Infectious Disease Research in Zambia.
Chomba MandyataDepartment of Community and Family Medicine, School of Public Health, University of Zambia.
Mwiche MusukumaDepartment of Epidemiology and Biostatistics, School of Public Health, University of Zambia.
Phoebe BwembyaDepartment of Community and Family Medicine, School of Public Health, University of Zambia.
Henry Phiri|Ministry of Health in Zambia, Lusaka, Zambia.
Malizgani P ChavulaDepartment of Community and Family Medicine, School of Public Health, University of Zambia.
Hikabasa HalwindiDepartment of Community and Family Medicine, School of Public Health, University of Zambia.
Joseph ZuluDepartment of Health Policy, School of Public Health, University of Zambia.
Wilbroad MutaleDepartment of Health Policy, School of Public Health, University of Zambia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeople living with HIV (PLWH) who use tobacco face significant public health risks compared to non-users, including an average loss of 12.3 years of life expectancy. Tobacco use increases the likelihood of non-communicable diseases (NCDs), such as cardiovascular diseases, hypertension, diabetes mellitus, and non-AIDS-related cancers.

aimThis study investigated factors associated with tobacco smoking and smokeless tobacco (SLT) use among PLWH in Zambia.

methodsData were obtained from a national cross-sectional survey involving 5,204 PLWH from 193 clinics across Zambia's 10 provinces. Tobacco smoking, SLT use, behavioral patterns, and clinical characteristics were assessed. Logistic regression was used to determine unadjusted (UOR) and adjusted odds ratios (AOR) at a 95% confidence interval (CI).

resultsAmong the 5,204 PLWH surveyed, 9.7% were current tobacco smokers (21.9% men, 3.7% women), while 1.4% used smokeless tobacco (1.81% men, 1.26% women). In the multivariable analysis, several factors were identified as predictors of tobacco smoking. Male individuals had significantly higher odds of smoking (AOR: 4.81, 95% CI: 3.36-6.90). In contrast, higher educational attainment was associated with lower odds of smoking (AOR: 0.29, 95% CI: 0.16-0.52). Alcohol consumption was associated with an increased likelihood of smoking (AOR: 4.97, 95% CI: 2.93-8.44). Additionally, overweight or obese individuals were less likely to smoke, with adjusted odds ratios of 0.55 (95% CI: 0.35-0.85) and 0.36 (95% CI: 0.17-0.79), respectively. Non-adherence to antiretroviral therapy (ART) was also associated with higher smoking rates (AOR: 1.75, 95% CI: 1.14-2.67). Similarly, several factors were identified as predictors of smokeless tobacco (SLT) use. Individuals with an annual income exceeding 4,000 ZMW had lower odds of using SLT (AOR: 0.31, 95% CI: 0.14-0.73). In contrast, alcohol users exhibited significantly higher odds of SLT use (AOR: 14.74, 95% CI: 1.99-109.02). Furthermore, non-adherence to ART was associated with an increased likelihood of SLT use (AOR: 3.32, 95% CI: 1.54-7.17).

conclusionsOur findings highlight the urgent need for targeted interventions to reduce tobacco use among PLWH in Zambia. Integrating these measures within the existing healthcare framework can maximize impact. Gender-specific programs addressing unique risk factors, alongside economic empowerment initiatives for low-income females, could help curb SLT use. Additionally, reinforcing ART adherence through tobacco cessation counseling within HIV care settings may lower smoking rates. Given the strong association between alcohol consumption and tobacco use, structured behavioral interventions and support programs should also be prioritized. Strengthening collaborations between health authorities and community organizations can further enhance accessibility and outreach. By embedding these strategies within primary care and ART clinics, Zambia can effectively reduce tobacco use among PLWH, ultimately improving overall health outcomes and strengthening HIV management efforts.

Indexed as

HIV InfectionsTobacco, SmokelessTobacco SmokingAdolescentAdultCross-Sectional StudiesFemaleHumansMaleMiddle AgedRisk FactorsTobacco UseYoung AdultZambia

Identifiers

PMID40658694
PMCPMC12258560

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.