Prevalence and Correlates of Snuff Use, and its Association With Tuberculosis, Among Women Living With HIV in South Africa

Abstract Introduction A higher proportion of people living with HIV (PLWH) smoke compared to the general population, but little information exists about the prevalence and correlates of smokeless tobacco use among PLWH. In South Africa, dry powdered tobacco is inhaled nasally as snuff. Methods A cross-sectional survey among PLWH attending three HIV clinics was conducted. Snuff use was assessed via self-report and urine cotinine. Results Given the low (3%) prevalence of snuff use among men, analysis was restricted to n = 606 nonsmoking women living with HIV. Half (n = 298, 49%) were snuff users, the majority of whom (n = 244, 84%) had a positive urine cotinine test. In adjusted analysis, snuff use was negatively associated with higher education (relative risk [RR] 0.55; 95% confidence interval [CI]: 0.39, 0.77) and mobile phone ownership (RR 0.83; 95% CI: 0.71, 0.98), and positively associated with ever having tuberculosis (TB) (RR 1.22; 95% CI: 1.03, 1.45). In adjusted analysis, with current TB as the outcome, snuff use was marginally statistically significantly associated with a twofold increase in odds of a current TB diagnosis (odds ratio [OR] 1.99; 95% CI: 0.98, 4.15). Discussion A high proportion of nonsmoking South African women living with HIV use snuff, which was a risk factor for TB. Additional research is needed to understand the relationship between snuff, TB, and other potential health risks. Implications PLWH have a higher prevalence of smoking than their seronegative peers, but there is a paucity of research on smokeless tobacco use in this population, especially in low-resource settings. TB is the leading cause of death among PLWH, and with improvements to HIV treatment and care, PLWH are at greater risk of tobacco-related diseases. We report an extremely high prevalence of snuff use among women living with HIV in South Africa. Further, in this population snuff use is positively associated with ever having a TB diagnosis, as well as currently having TB.

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Potential health impacts and lung microbiome changes among smoking and smokeless tobacco use : A technical scan

Eurasian Journal of Pulmonology ◽

10.4103/ejop.ejop_108_20 ◽

2021 ◽

Vol 23 (2) ◽

pp. 77

Author(s):

Krishnan Srinivasan ◽

Manikandan Sathiyaseelan ◽

JenethBerlin Raj ◽

Pajanivel Ranganadin ◽

Balanehru Subramanian

Keyword(s):

Tobacco Use ◽

Smokeless Tobacco ◽

Health Impacts ◽

Potential Health ◽

Lung Microbiome ◽

Smokeless Tobacco Use

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Prevalence and Correlates of Smokeless Tobacco Use Among Grade 8–11 School Students in South Africa: A Nationwide Study

Nicotine & Tobacco Research ◽

10.1093/ntr/ntu044 ◽

2014 ◽

Vol 16 (9) ◽

pp. 1167-1173 ◽

Cited By ~ 1

Author(s):

Priscilla S. Reddy ◽

Shamagonam James ◽

Ken Resnicow ◽

Ronel Sewpaul ◽

Pardon Masuka ◽

...

Keyword(s):

South Africa ◽

Tobacco Use ◽

Smokeless Tobacco ◽

School Students ◽

Nationwide Study ◽

Smokeless Tobacco Use ◽

Grade 8

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Fertility intentions of women living with HIV and their male partners during the perinatal period in rural South Africa

International Journal of STD & AIDS ◽

10.1177/0956462420987447 ◽

2021 ◽

pp. 095646242098744

Author(s):

Lissa N Mandell ◽

Violeta J Rodriguez ◽

Karl Peltzer ◽

Stephen M Weiss ◽

Deborah L Jones

Keyword(s):

South Africa ◽

Perinatal Care ◽

Healthcare Providers ◽

Male Involvement ◽

Fertility Intentions ◽

People Living With Hiv ◽

Male Partners ◽

Safer Conception ◽

Women Living With Hiv ◽

Living With Hiv

Understanding the fertility intentions of people living with HIV can guide safer conception planning and prevention of mother-to-child transmission (PMTCT). Most research has addressed fertility intentions among women, rather than couples, at a single time point. This clinical trial of a PMTCT intervention in rural Mpumalanga province, South Africa, examined longitudinal fertility intentions among perinatal women living with HIV and their male partners. Study assessments and intervention and control sessions were conducted prenatally and postpartum. Longitudinal predictors of participants’ ( n = 360 men, n = 917 women) fertility intentions were similar between sexes. Younger age and male involvement in perinatal care were associated with reporting fertility intentions at both baseline and 12 months postpartum. Having an HIV-positive infant and discussing pregnancy plans with a healthcare provider by 12 months postpartum were associated with incident fertility intentions after reporting no plans for further children at baseline. Results highlight the important role of healthcare providers to educate men and women on issues surrounding conception, as well as the potential for incorporating PMTCT and safer conception education into HIV clinical services.

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Water Pipe and Smokeless Tobacco Use Among Medical Students in South Africa

Nicotine & Tobacco Research ◽

10.1093/ntr/ntr211 ◽

2011 ◽

Vol 14 (6) ◽

pp. 755-760 ◽

Cited By ~ 12

Author(s):

F. Senkubuge ◽

O. A. Ayo-Yusuf ◽

G. M. C. Louwagie ◽

K. S. Okuyemi

Keyword(s):

South Africa ◽

Medical Students ◽

Tobacco Use ◽

Smokeless Tobacco ◽

Water Pipe ◽

Smokeless Tobacco Use

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Tobacco use and nicotine dependence among people living with HIV who drink heavily in South Africa: a cross-sectional baseline study

BMC Public Health ◽

10.1186/s12889-019-8047-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Catherine O. Egbe ◽

Mukhethwa Londani ◽

Charles D. H. Parry ◽

Bronwyn Myers ◽

Paul A. Shuper ◽

...

Keyword(s):

South Africa ◽

At Risk ◽

Nicotine Dependence ◽

Tobacco Use ◽

Tobacco Product ◽

Relative Risk Ratio ◽

People Living With Hiv ◽

Regression Analyses ◽

Factors Associated ◽

Living With Hiv

Abstract Background People living with HIV (PLWH) who drink alcohol and use tobacco are particularly vulnerable to tobacco-induced diseases due to an already compromised immune system. This study investigated the prevalence and factors associated with tobacco use (cigarette and snuff) among PLWH who drink heavily. Methods Participants (n = 623) on antiretroviral therapy for HIV who reported heavy drinking using the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-C were recruited from six hospitals in Gauteng Province, South Africa. The Fagerström test was used to assess nicotine dependence. Chi Square tests and modified Poisson regression analyses were conducted to identify factors associated with tobacco use. Results Almost half of the participants reported ever smoking (44.0%; CI: 40.1–47.9) and about a quarter reported ever using snuff (25.5%; CI: 22.2–29.1). Current smokers and current snuff users comprised 27.3% (CI: 23.9–30.9) and 19.1% (CI: 16.2–22.3) of all participants respectively. Among current smokers, 37.9% (CI: 30.8–45.3) were moderately/highly dependent on nicotine. Current ‘any tobacco product users’ (ATPU: use cigarettes or snuff) were 45.4% (CI: 41.5–49.3) while 1.0% (CI: 0.4–2.0) currently used cigarettes and snuff. Adjusted regression analyses showed that, compared to males, females were less at risk of being: ever smokers (Relative Risk Ratio [RRR] = 0.33; CI: 0.27–0.41), current smokers (RRR = 0.18; CI: 0.12–0.25), and ATPU (RRR = 0.75; CI: 0.63–0.89) but were more at risk of ever snuff use (RRR = 5.23; CI: 3.31–8.25), or current snuff use (RRR = 26.19; CI: 8.32–82.40) than males. Ever snuff users (RRR = 1.32; CI: 1.03–1.70), current snuff users (RRR = 1.40; CI: 1.03–1.89) and ATPU (RRR = 1.27; CI: 1.07–1.51) were more at risk of reporting significant depressive symptoms. We found no significant associations between smoking status and years on ART and viral load. Conclusion There is a high prevalence of cigarette and snuff use among PLWH who drink heavily. Tobacco use cessation interventions tailored specifically for this population and according to their tobacco product of choice are urgently needed given their vulnerability to ill-health.

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