Estimates of Prevalence, Time-Trend, and Association of Smoking in Adults Living with HIV, HBV, and HCV (NHANES 1999–2018)

Although the smoking rate of HIV, HBV or HCV infected people is much higher than that of the general population, smoking cessation interventions have long been ineffective. Therefore, further understanding of the underlying social reasons behind the poor behavior of this population is needed. We aimed to examine the estimates of prevalence, time-trend, and association of smoking among people living with HIV, HBV, or HCV. This cohort was composed of 32,115 individuals from the National Health and Nutrition Examination Survey (NHANES 1999–2018). All adults aged 21–59 who self-reported smoking status and had been tested for HIV, HBV, and HCV were included in this analysis. The time trend analysis of smoking and quitting rates in different years of survey follow-up and different infected populations. Multivariable logistic regression analysis was used to identify the risk factors related to smoking behavior of HIV|HBV|HCV infected people. Overall, the smoking rates of the people infected HIV|HBV|HCV were 1.35–1.93 times higher from 1999 to 2018. Compared to smokers without HIV&HBV&HCV, smokers living with HIV|HBV|HCV were more likely to be older (aged 30–39, 9.92, 6.07 to 16.21; aged 40–49, OR = 3.51, CI = 2.49 to 4.94), more males (1.99, 1.54 to 2.55), lower education level (1.78, 1.39 to 2.29), lower economic level (2.05, 1.59 to 2.65), unemployed (1.63, 1.21 to 2.20), suffering depression (1.35, 1.05 to 1.72), and drug users (7.65, 5.04 to 11.59). Taken together, studies have shown that complex psychosocial characteristics and behavioral factors, including individual economic status, mental diseases (such as depression) and illegal drug use (such as marijuana and heroin) hinder their efforts to quit smoking. Therefore, it is very important to take targeted smoking cessation interventions to meet the unique situation and needs of this special group.