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A Cross-Sectional Analysis of the Nicotine Metabolite Ratio and Its Association with Sociodemographic and Smoking Characteristics among People with HIV Who Smoke in South Africa

Author

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  • Chukwudi Keke

    (Department of Environmental and Radiological Health Science, Colorado State University, Fort Collins, CO 80523, USA
    These authors contributed equally to this work.)

  • Zane Wilson

    (Department of Environmental and Radiological Health Science, Colorado State University, Fort Collins, CO 80523, USA
    These authors contributed equally to this work.)

  • Limakatso Lebina

    (Africa Health Research Institute, Somkhele, Myeki 3935, South Africa)

  • Katlego Motlhaoleng

    (Perinatal HIV Research Unit, Soweto 1862, South Africa)

  • David Abrams

    (School of Global Public Health, New York University, New York, NY 10003, USA)

  • Ebrahim Variava

    (Klerksdorp Tshepong Hospital Complex, Matlosana 2574, South Africa)

  • Nikhil Gupte

    (Department of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA)

  • Raymond Niaura

    (School of Global Public Health, New York University, New York, NY 10003, USA)

  • Neil Martinson

    (Perinatal HIV Research Unit, Soweto 1862, South Africa)

  • Jonathan E. Golub

    (Department of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA)

  • Jessica L. Elf

    (Department of Environmental and Radiological Health Science, Colorado State University, Fort Collins, CO 80523, USA)

Abstract

The nicotine metabolite ratio (NMR) is associated with race/ethnicity but has not been evaluated among smokers in the African region. We conducted a cross-sectional analysis of baseline data from a large randomized, controlled trial for smoking cessation among people with HIV (PWH) in South Africa. Urine samples were analyzed for the NMR and evaluated as a binary variable using a cutoff value of the fourth quartile to determine the fastest metabolizers. The median NMR was 0.31 (IQR: 0.31, 0.32; range: 0.29, 0.57); the cut-point for fast metabolizers was ≥0.3174 ng/mL. A high NMR was not associated with the number of cigarettes per day (OR = 1.10, 95% CI: 0.71, 1.70, p = 0.66) but was associated with 40% lower odds of a quit attempt in the past year (OR = 0.69; 95% CI: 0.44, 1.07, p = 0.09) and alcohol use (OR = 0.59, 95% CI: 0.32, 1.06, p = 0.07). No association was seen with marijuana or HIV clinical characteristics. As we found only minimal variability in the NMR and minimal associations with intensity of smoking, NMR may be of limited clinical value in this population, although it may inform which individuals are less likely to make a quit attempt.

Suggested Citation

  • Chukwudi Keke & Zane Wilson & Limakatso Lebina & Katlego Motlhaoleng & David Abrams & Ebrahim Variava & Nikhil Gupte & Raymond Niaura & Neil Martinson & Jonathan E. Golub & Jessica L. Elf, 2023. "A Cross-Sectional Analysis of the Nicotine Metabolite Ratio and Its Association with Sociodemographic and Smoking Characteristics among People with HIV Who Smoke in South Africa," IJERPH, MDPI, vol. 20(6), pages 1-8, March.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:6:p:5090-:d:1096546
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    References listed on IDEAS

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    1. Feldman, J.G. & Minkoff, H. & Schneider, M.F. & Gange, S.J. & Cohen, M. & Watts, D.H. & Gandhi, M. & Mocharnuk, R.S. & Anastos, K., 2006. "Association of cigarette smoking with HIV prognosis among women in the HAART era: A report from the women's interagency HIV study," American Journal of Public Health, American Public Health Association, vol. 96(6), pages 1060-1065.
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