JMIR Publications

ABSTRACT

Background:

China, where over half of the male adult population smoke tobacco, has one of the highest global burdens of smoking. Smoking rates are even higher among people with HIV (PWH). Smoking cessation services are not routinely integrated into HIV care in China. Given widespread mobile phone ownership, an exploration of factors related to smoking among Chinese PWH who smoke could inform potential mobile cessation interventions.

Objective:

To explore perspectives of smoking, barriers and facilitators to quitting, and perceptions related to a smoking cessation intervention delivered through behavioral counseling sessions and brief messenger service-delivered messages.

Methods:

We conducted semi-structured interviews with 24 participants. Interviews were audio-recorded, transcribed verbatim in Chinese, then translated into English for data analysis. We conducted a thematic analysis using a team-based consensus approach.

Results:

The mean age was 37.2 years; participants lived with HIV for an average of 2.4 years. The majority were male (75%) and lived in urban/metropolitan settings (79%). We identified 5 main themes: variable knowledge of the harms of smoking; willpower perceived as the primary quitting strategy; a duality of the effect of social factors on quitting; perceptions about optimal features of the smoking cessation intervention (e.g., messages should be brief and frequent); and the largely negative impact of their HIV diagnosis on smoking behaviors. In addition, some themes differed by participant demographic characteristics.

Conclusions:

We identified barriers and facilitators to smoking cessation among PWH in China, which can be incorporated into smoking cessation interventions using behavioral counseling and messenger service-derived brief messages. Due to the adverse impact of smoking on HIV outcomes, targeting cessation interventions to the unique needs and preferences of PWH in China may be needed to increase future intervention effectiveness.