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Predictors of tobacco smoking abstinence among tuberculosis patients in South Africa

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Abstract

This study examines predictors of smoking cessation in tuberculosis patients with high HIV co-infection rates in a South African primary care setting. Current smokers were randomly allocated to brief motivational interviewing (n = 205) or receipt of a brief message (n = 204). Multi-level logistic regression was performed to identify predictors of sustained 3- and 6-month abstinence and 7-day point prevalence abstinence (PPA) at 1 month, with the facility as a random effect. The intervention was ineffective among smokers with high nicotine-dependence at 1 month, but was effective for all smokers over longer periods. Higher baseline self-efficacy predicted the 1-month 7-day PPA, but not sustained abstinence. HIV-positive participants’ odds of sustained abstinence were about three times higher than those of their HIV-negative counterparts. Results support a more intensive motivational intervention and/or coping skills’ training to increase self-efficacy and abstinence rates. Tobacco cessation services can be introduced in tuberculosis services where high HIV co-infection rates occur.

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Acknowledgments

This project was supported by funding from the KNCV Tuberculosis Foundation (Grant 12.402.2/MvdW/U.10.0696/cal), Global Bridges Health Care Alliance for Tobacco Dependence Treatment and the National Research Foundation of South Africa (Grant# 80843). The National Council against Smoking of South Africa provided the smoking cessation booklets offered to the study participants. We are grateful to the fieldworkers and supervisory staff, in particular Ms K. Kodi, for their enthusiastic and hard work. We also wish to thank the TB nurses at the facilities and the Tshwane District Health management team for their support.

Conflict of interest

The funders had no role in the conceptualisation of the study, data analysis or reporting of results. Goedele M. C. Louwagie declares no conflict of interest. Olalekan A. Ayo-Yusuf is a sub-awardee of an unrestricted Pfizer Education grant to the Mayo clinic for the Global Bridges Health Alliance project and received an honorarium as a speaker at the 2012 Congress of the South African Dental Association for a session on treatment funded by Pfizer.

Human and Animal Rights and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Faculty of Health Sciences, School of Health Systems and Public Health, University of Pretoria, Private Bag X 323, Pretoria, 0001, Republic of South Africa

    Goedele M. C. Louwagie & Olalekan A. Ayo-Yusuf

  2. Dean/Director’s Office, Faculty of Health Sciences, School of Oral Health Sciences, University of Limpopo/MEDUNSA Campus, PO Box 197, Ga-Rankua/Tshwane, Gauteng, 0204, Republic of South Africa

    Olalekan A. Ayo-Yusuf

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  1. Goedele M. C. Louwagie
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Correspondence to Goedele M. C. Louwagie.

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Louwagie, G.M.C., Ayo-Yusuf, O.A. Predictors of tobacco smoking abstinence among tuberculosis patients in South Africa. J Behav Med 38, 472–482 (2015). https://doi.org/10.1007/s10865-015-9620-y

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