The effects of smoking on people with HIV David Rowlands examines why smoking is a particularly serious health threat for people living with HIV and explores a range of interventions and the views of the community based on his latest poll. Why is smoking more dangerous for people with HIV?
As many as 50-70 per cent of people infected with HIV are smokers. Smoking can interfere with normal lung function in healthy people. In people with HIV, it can make it more difficult to fight off serious infections. Today, people who have HIV can live just as long as those who don’t, so it’s easy to forget the hazards of the chronic illness. Smoking and related problems can interfere with long-term quality of life and recent studies show that smokers with HIV lose more years of life from smoking than from HIV. Smoking can also interfere with the processing of medications by the liver. It can also worsen liver problems like hepatitis.
Smoking and side effects
People with HIV who smoke are more likely to suffer complications from HIV medication than those who don’t, often suffering from nausea and vomiting. Smoking increases the risk of some long-term side effects of HIV disease and treatment. These include osteoporosis (weak bones that can lead to fractures) and osteonecrosis (bone death). HIV treatment slightly increases the risk of heart attack, but smoking is the major controllable risk factor for heart attacks or strokes. Recent studies found that quitting smoking reduced heart attack risk in HIV patients more than other factors such as changes in
medications. Smoking and opportunistic infections People with HIV who smoke are more likely to develop opportunistic infections related to HIV, including thrush, oral hairy leukoplakia (whitish mouth sores), bacterial pneumonia and pneumocystis pneumonia (PCP). For women, smoking can increase the risk and severity of infection with human papilloma virus (HPV), which increases the risk of cervical disease. Recently, the bacteria that cause Mycobacterium avium complex (MAC) were linked to smoking. They were found in tobacco, cigarette paper and filters even after they had been burned.
Smoking and risk of death
A recent study found that smoking was linked to a higher rate of death among people with HIV. This was true for current smokers and ex-smokers. The greatest increase in the risk of death was 60 per cent for cardiovascular (heart) disease and some cancers.
Quitting smoking
Quitting is easier said than done, especially since smoking is so entrenched in many niche communities of people with HIV. Smoking (nicotine) is highly addictive and difficult to stop. There is no one way to give up; some people go ‘cold turkey’ and just stop. Others need some kind of support, ranging from medications that manage the physical symptoms of withdrawal to therapies that deal with the psychological addiction.
David Rowlands
Some people alter the routines that encourage them to smoke, get support to reduce outside factors like stress that encourage them to smoke, and participate in motivational groups. Others have success with alternative treatments like acupuncture.
E-cigarettes
British public health officials have said electronic e-cigarettes should be available on the NHS, despite conflicting evidence over their safety. Britain’s eight million smokers have been urged to start ‘vaping’ after a government-backed report found that the electronic devices are 20 times less harmful than traditional cigarettes. A new report launched by Public Health