Why Vietnamese men with HIV struggle to quit smoking despite high risks

A new qualitative study has examined the challenges men living with HIV in Vietnam face when trying to quit smoking. The research, led by Hoang, T.HL., Nguyen, C.V., and Alvarez, G.G., highlights how stigma and fear of judgement often prevent these individuals from seeking help. With smoking rates among this group reaching as high as 90% in certain demographics, the findings point to systemic and social barriers that hinder cessation efforts.

Current estimates from UNAIDS and Vietnam's health reports (2023–2025) indicate that between 120,000 and 150,000 men living with HIV in the country are smokers. This represents 70–85% of the roughly 190,000 male population with HIV. Regional differences show higher smoking rates in urban centres like Hanoi and Ho Chi Minh City (80–90%) compared to rural northern provinces (60–70%). The highest prevalence appears among men aged 25–44 (85%) and injecting drug users (90%).

The study identifies multiple obstacles to quitting. Fear of judgement in healthcare settings discourages many from disclosing their smoking habits or seeking cessation support. Limited access to resources and insufficient training among providers further complicate efforts. Additionally, societal stigma around HIV creates an environment where men avoid discussing their struggles openly.

Despite these challenges, certain approaches show promise. Telehealth provides a flexible way for young men to access cessation programmes without facing in-person stigma. Peer support and community networks also play a vital role in successful quitting attempts. Integrated care models, which address both smoking and psychosocial needs, have proven more effective for long-term cessation.

Healthcare providers themselves can make a difference. Culturally competent and empathetic staff help create supportive environments where patients feel safe discussing their habits. Health literacy, mental well-being, and societal attitudes all intersect to shape cessation outcomes.

The study underscores the need for targeted interventions to help men living with HIV in Vietnam quit smoking. Telehealth, peer support, and integrated care models offer practical solutions to existing barriers. Addressing stigma and improving provider training could further enhance cessation success rates for this high-risk group.