Decreased Awareness of Current Smoking Among Health Care Providers of HIV-Positive Compared to HIV-negative Veterans
Cigarette smoking is a leading cause of disease and mortality in the United States. For HIV-positive individuals, smoking is associated with increased disease progression, decreased quality of life and mortality, particularly in this era of antiretroviral therapy. The objective of this study was to determine whether health care providers are aware of their HIV patients' smoking status, and whether that awareness differs between HIV and general medical care providers. The researchers studied 801 HIV-positive and 602 HIV-negative patients, and 72 HIV and 71 general medical providers. The patients were enrolled in the Veterans Aging Cohort 5 Site Study. Data sources included patient and provider questionnaires, electronic medical records and the national administrative VA database. The researchers found that more than 90 percent of HIV and non-HIV practitioners correctly identified a patient as a current smoker, though HIV providers failed to recognize current smokers 35 percent of the time compared to 18 percent of the time for non-HIV providers. Bothersome coughs, a history of coronary heart disease, chronic obstructive pulmonary disease, immune competence, or viral load status did not increase the recognition of current smokers. Only 39 percent of HIV care providers reported confidence in their ability to influence smoking cessation compared to 62 percent of non-HIV providers. These findings support the need for increased training of HIV providers in smoking cessation techniques and programs.