Tobacco Smoking and Associated Factors among People Living with HIV in Uganda

N.D. Mdege, F.E. Makumbi, R. Ssenyonga, F. Thirlway, J.K.B. Matovu, E. Ratschen, K. Siddiqi, K. Nyamurungi Namusisi

Research output: Contribution to journalArticlepeer-review


The prevalence of smoking among people living with HIV (PLWH) in Uganda is high.

Aims and Methods
We assessed the smoking patterns, behaviors, and associated factors among PLWH in Uganda through a cross-sectional survey. Descriptive statistics were used to describe smoking patterns and behaviors. Logistic regression was used to identify factors associated with current smoking status.

We recruited 777 participants between October and November 2019: 387 (49.8%) current smokers and 390 (50.2%) nonsmokers. 60.9% were males, and the mean age was 40.5 (SD 10.7) years. In multivariate logistic regression, the following increased the odds of being a current smoker: being male (odds ratio [OR] 6.60 [95% confidence interval, CI = 4.34–10.04]), having at least two smokers among five closest friends (OR 3.97 [95% CI = 2.08–7.59]), living in smoking-permitted households (OR 5.83 [95% CI = 3.32–10.23]), alcohol use (OR 3.96 [95% CI = 2.34–6.71]), a higher perceived stress score (OR 2.23 [95% CI = 1.50–3.34]), and higher health-related quality of life (OR 5.25 [95% CI = 1.18–23.35]). Among smokers, the mean Fagerström Test for Nicotine Dependence score was 3.0 (SD 1.9), and 52.5% were making plans to quit. Self-efficacy to resist smoking and knowledge of the impact of smoking on PLWH’s health were low.

Being male, having at least two smokers among five closest friends, living in smoking-permitted households, alcohol use, higher perceived stress scores, and higher health-related quality of life were associated with being a current smoker. Smokers had low to moderate nicotine dependence, high willingness to quit, and low self-efficacy.

Future behavioral smoking cessation interventions for PLWH should address co-consumption with alcohol and comorbid mental health conditions that are common among PLWH such as stress. In addition, they should take into account the lack of knowledge among this population of the impact of smoking on their health, and low self-efficacy. Given the relatively low levels of nicotine dependency and high levels of willingness to quit in our sample, smoking cessation interventions, if offered, are likely to support this population in achieving long-term smoking abstinence.
Original languageEnglish
Pages (from-to)1208-1216
Number of pages9
JournalNicotine and Tobacco Research
Issue number7
Publication statusPublished - 9 Dec 2020

Bibliographical note

Copyright © The Author(s) 2020. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.


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