Smoking, nicotine product use, and cessation support gaps among people using harm reduction services in Kyrgyzstan: a cross-sectional study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background Smoking is disproportionately high among people receiving substance use treatment or harm reduction services, yet tobacco-dependence support is often not integrated into routine care. Evidence on the use of different nicotine products in these settings remains limited. We examined nicotine-product use, service-support gaps, smoking quit intentions and multidomain barriers in Kyrgyzstan. Methods We conducted a cross-sectional survey among 349 adults recruited through service- and outreach-based convenience sampling in Bishkek/Chüy and Osh/Osh. Interviews assessed nicotine and psychoactive-substance use, cessation beliefs, risk perceptions, affordability and availability, and service support. Adjusted logistic regression examined no intention to quit smoking within 12 months; daily nasvay use versus exclusive daily smoking; and daily e-cigarette or heated tobacco product use versus exclusive daily smoking. Results Current nicotine-product use was 98.9%, current smoking 90.8%, and daily smoking 79.9%. Current and daily nasvay use were 28.1% and 16.0%. Among daily smokers, 73.1% did not intend to quit within 12 months. Among 324 current smokers or nasvay users, 68.2% had not been advised to quit, 96.9% had not been offered personal help, 99.4% had no follow-up appointment, and 97.5% had not been encouraged to use nicotine replacement therapy. No quit intention was associated with low concern about smoking (AOR 6.84, CI 3.13–14.96) and disagreement that people who use drugs who smoke or use smokeless tobacco want to quit (AOR 3.56, CI 1.74–7.29). Disagreement that nasvay is safer than smoking was associated with lower odds of daily nasvay use (AOR 0.095, CI 0.036–0.250). Two relative-risk measures were associated with daily e-cigarette/heated tobacco product use but involved small groups. Conclusions Nicotine-product use was nearly universal in this service-based sample, with daily smoking predominant and nasvay an important secondary product. Tobacco-dependence support was rarely reported. The findings support evaluating integrated cessation support and product-specific risk communication within harm reduction services. Clinical trial number Not applicable.
Source: BMC Health Services Research
Institutions: University of Warsaw, Imperial College London
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,290
OpenAlex ID: W7161043696