Assessment of awareness and use of electronic cigarettes among people living with HIV

Tobacco use is disproportionately high among people living with HIV (PLWH), increasing tobacco-related morbidity and mortality and potentially undermining antiretroviral therapy adherence. We conducted a cross-sectional survey of 88 PLWH attending a university infectious diseases outpatient clinic (mean age 40.8 ± 10.9 years; 97.7% male). Sociodemographic characteristics, smoking history, quit attempts, and awareness of electronic cigarettes (e-cigarettes) were collected using a structured questionnaire, and nicotine dependence was measured with the Fagerström Nicotine Dependence Test. Mean dependence score was 3.94 ± 2.55 and was higher in participants with lower versus higher education (4.45 ± 2.62 vs 3.17 ± 2.26; mean difference 1.28, 95% CI 0.24 to 2.32; p = 0.020). Although 76.1% had attempted to quit, only 18.2% reported receiving professional support. Friends were the main source of e-cigarette information (60.2%). Only 21.6% considered e-cigarettes a tobacco product, while 44.3% did not. Most participants (76.1%) believed e-cigarettes are harmful. Smoking cessation services embedded in HIV care should address nicotine dependence and misinformation about e-cigarettes through targeted, multidisciplinary interventions.