Smoking and HIV: time for a change?

Abstract

Cigarette smoking is one of the most important causes of morbidity and mortality in the general population, and is a well-recognized risk factor for a variety of serious clinical conditions, including cardiovascular diseases, pulmonary diseases and cancers. Smoking-related morbidity and mortality are of particular concern in patients with HIV infection, as the prevalence of current cigarette smoking is higher among HIV-positive patients than among the general population. In a study by De et al., it has been evidenced that smoking is a risk factor for bacterial pneumonia in HIV-positive patients and smoking cessation reduces this risk. HIV-positive patients who smoke have significantly increased mortality compared to those who have never smoked, indicating that smoking confers different mortality risk in HIV-positive as compared to HIV-negative patients, and lifestyle-related factors may pose a greater hazard to long-term survival of HIV-positive patients than those related to the HIV infection per se. The high prevalence of smoking among HIV population, the many health risks that can result from this behavior, and the proven efficacy of cessation interventions in HIV-positive patients should encourage HIV care providers to make smoking cessation a high priority.