HIV and Smoking in Eswatini: Gaps and Opportunities for Cessation and
Harm Reduction
Abstract
According to the Centers for Disease Control and Prevention (CDC),
people living with HIV are at higher risk of smoking consequences than
persons without HIV. Eswatini has put efforts in place to curb smoking
in the country such as restriction of smoking in designated areas,
prohibition of tobacco advertising and promotion, restrictions on
tobacco packaging and labelling, but there is a dearth of literature to
provide evidence on available smoking cessation programs in the country.
This study aims to review and analyze the current state of smoking
cessation programs in the country particularly for people living with
HIV, and provide recommendations for a smoking cessation and tobacco
harm reduction framework for persons living with HIV. Official documents
including the National Multisectoral HIV and AIDS Strategic Framework
(2018 - 2023) and the Eswatini Integrated HIV Management Guidelines
(2022) provide recommendations for the screening of lifestyle factors
including smoking and advice for quitting. However, sufficient light is
not shed on the processes for caring for PLHIV who also smoke. The study
concludes that smoking cessation and harm reduction programs for persons
who smoke have not been effectively incorporated into national
guidelines and programs for persons living with HIV, and thus the
development of a prototype framework to guide healthcare professionals
in delivering care for PLHIV who smoke across the different care models
for ART delivery, including the use of Safer Nicotine products (SNPs)
when necessary, can be discussed in the review of national HIV care
documents.