ArticleTobacco prevention & cessation2026
Barriers and facilitators to delivering tobacco cessation interventions at HIV care clinics in Sub-Saharan Africa: Qualitative application of the consolidated framework for implementation research.
Article in Tobacco prevention & cessation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
Abstract
Introduction: Tobacco use among people living with HIV (PLWH) in Sub-Saharan Africa (SSA) is prevalent, compounding health risks. Tobacco cessation interventions (TCIs) have shown promise but are not widely tested in HIV care settings. In this study, we applied the Consolidated Framework for Implementation Research (CFIR) to examine barriers and facilitators to implementing the adapted tobacco cessation intervention Quit4life+ for PLWH in Uganda and Zambia. Methods: Guided by the CFIR determinant framework, Quit4life+ trial implementation challenges were evaluated across 16 HIV clinics in Uganda and Zambia between July 2021 and October 2025. Qualitative data were drawn from multiple sources, including 22 quarterly site visit reports, 4 health systems assessments completed by study coordinators and health facility personnel in-charge, key informant interviews with 14 clinic healthcare providers (nurses, nursing officers, and midwives), and focus group discussions with 55 PLWH (aged ≥18 years and receiving HIV care at participating clinics). Qualitative data were mapped to relevant domains and constructs. Results: Within the innovation domain, evidence for TCIs, nicotine replacement therapy (NRT), and culturally adapted message libraries enhanced acceptability, while costs challenged adoption. Outer setting challenges, including seasonal labor demands, civil unrest, poor road access, and restrictive procurement and regulatory processes, influenced delivery. Inner setting barriers included overcrowded clinics, limited counseling space, inconsistent network connectivity, and staff turnover. Providers were motivated to support cessation but reported limited skills and faced intersecting stigma among patients. The implementation process relied on external resources, raising concerns about sustainability. Conclusions: Findings identify multilevel barriers and facilitators to delivering cessation support within HIV care clinics in Uganda and Zambia. Further research is needed to determine how determinants can be effectively addressed and to build the evidence base for the sustainable integration of services into HIV care across SSA.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.