Subscribe to our RSS feed

Popular News Stories

  • Fuck poz guys!
  • Tom Hanks in Philadelphia Changed my Life
  • Canadian AIDS Society’s AGM and PHA Forum in Ottawa: some scholarships for HIVers available
  • Semen goes viral – or does it?

Smoking Cessation

Sep15

Smoking and HIV

Monday, 15 September 2014 Written by // Guest Authors - Revolving Door Categories // Health, Smoking Cessation , International , Living with HIV, Revolving Door, Guest Authors

A UK perspective on smoking and HIV and why, if you smoke, you should probably think about quitting, from GMFA

Smoking and HIV

We all know that smoking is dangerous, and that stopping smoking can improve your health and reduce the risk of smoking-related illnesses whether you’re HIV positive or not. However, smoking can be even more damaging to your health if you have HIV [1]. 

Smoking has not been shown to make HIV progress any faster than in non-smokers; however, HIV positive smokers are at a higher risk of smoking related illnesses than HIV negative smokers, and smoking has been shown to increase the risk of HIV-related illnesses occurring [2].

Compared to HIV negative smokers, HIV positive smokers are at an increased risk of developing illnesses such as:

  • Cardiovascular events such as high blood pressure, heart disease and heart attacks [3]
  • Cerebrovascular events such as strokes [4]
  • Malignancies such as lung cancer, anal cancer, mouth cancer, throat cancer, stomach cancer, head and neck cancer [5]
  • Decreased lung function, chest infections, chronic inflammation of the lungs and airways [6]
  • Emphysema and chronic bronchitis [7]
  • Mouth problems such as gingivitis, periodontitis, thrush and OHL [8]
  • Brain degenerative disorders such as impaired cognitive function and dementia [9] 

These illnesses aren’t necessarily more common in HIV positive smokers because of an immune system weakened by HIV. For example, lung cancer is now one of the most common types of non-AIDS defining cancers seen in HIV positive people, and it often occurs in people with high CD4 counts, and therefore with immune systems as strong as you would find in many HIV negative people.

Moreover, illnesses such as lung cancer and emphysema are being diagnosed in HIV positive smokers whilst they are still relatively young – often under the age of 40.

If you have a lower CD4 count and smoke then the risks of you getting an AIDS-defining opportunistic infection are higher, especially those affecting the mouth, lungs and airways. HIV positive smokers with low CD4 counts are therefore at a higher risk of infections such as oral hairy leukoplakia, bacterial pneumonia and thrush. More worryingly, smoking also increases the risk of developing PCP if you have a low CD4 count, and this infection can prove fatal.

It’s obvious that you would therefore experience major health benefits from stopping smoking. Some HIV doctors have gone on record as saying that, other than adhering to HIV treatments, stopping smoking is the single most important thing that HIV positive people can do to improve their health and life expectancy. The good news is that with the smoking cessation support and new anti-smoking treatments now available, there’s never been a better time to quit. 

Stopping smoking

If you want to stop smoking then thinking about the reasons why you don’t want to smoke may give you an incentive. On top of the damage smoking can do to your health, there are financial considerations. A 20-a-day smoker will spend over £2,000 in a year on cigarettes. If you stopped smoking then that £2,000 could buy you a luxury tropical beach holiday every year instead!

If you have decided to stop, then plan ahead so you can prepare yourself. Get rid of ash trays or anything else that reminds you of smoking from your home. If you have difficulty dealing with cravings, remind yourself that cravings will usually pass after five minutes or so. Little tricks like drinking a glass of cold water when you have cravings or distracting yourself by doing something active and keeping busy really can help. Just take it one day at a time and before you know it a month will have passed and you’ll be well on the way to being smoke free.

It may help if you go on a smoking cessation course and use smoking cessation aids such as Nicotine Replacement Therapy (NRT – such as nicotine gum or patches) or one of the drugs Zyban or Champix.

Many local NHS services will offer free generic smoking cessation courses. Speak to your HIV doctor or GP to see what help is available in your area.

Quit is a charity whose aim is to help people to stop smoking. You could call the Quitline on 0800 00 22 00 to talk to a counsellor who will offer confidential help and advice, or visit their website www.quit.org.uk.

You can also find information about how to stop smoking, as well as details of local stop smoking services near where you live on the NHS website www.gosmokefree.co.uk.

Herbal tobacco

Some people who experience pain because of their illness, such as men with peripheral neuropathy due to HIV or anti-HIV drugs, use cannabis to help ease the pain. If you do use cannabis and usually smoke it, you’ll need to think about how you’re going to get by without using tobacco. Some people choose to use pipes or even herbal tobacco, whereas others choose to eat the drug instead. Remember though that as well as cannabis being a controlled substance, and as such illegal to supply or possess, continuing to smoke it either through pipes or with herbal tobacco still carries a lot of the health risks that smoking tobacco does. If you choose to eat it, also remember that a small amount goes a long way, and you need much less than if you smoke it. You can read more about cannabis and HIV in the section on Recreational Drugs.

"When I was diagnosed with HIV, I thought, like many recently diagnosed men, 'that's it, I'm dying young so I may as well live fast'. I saw no need to change any of my many bad habits, I reckoned AIDS was going to get me before cancer did. Four years and lots of encouraging treatment news later it was time to re-evaluate. I was approaching 35, a scary age for many gay men, and had been nursing my 20 a day habit (40 on party nights) for fully half my lifetime. I'd tried to ignore all of the health warnings about HIV positive smokers being more susceptible to cancer and other respiratory illnesses but I was old enough and ugly enough now to take the truth. I had to say to myself, 'what about my life to date makes me think that I'm not going to get cancer?' It also had become clear to me that cigarettes didn't actually calm my nerves, just that their absence stressed me out. If I could just get over that withdrawal I should feel less stressed generally. I'd tried to stop before and failed, so this time I joined a group. I can't say that everything about the Stop Smoking Course appealed to me, however it did mean that by the time I got to the quit date I'd invested so much effort already that I was determined not to fail again. I used nicotine patches for about two and a half months, which helped me not to think about how much I missed my little tubes of delight. After that time I was so over the whole fag thing I was amazed to think I'd wasted all that time and all of that money smoking. The money in your pocket at the beginning of the day is often still there at the end of the day, and suddenly you find you can afford exotic holidays and nice meals out (my habit had been costing me about £2000 per year) and the whole concept of smoking seems rather silly to me now. Also I'm back to thinking that I may live long enough to retire now, so I'll probably be needing that extra cash." (Mark, 37).

References

1 Tirreli, U., Spina, M., Sandri, S., Serraino, D., Gobitti, C., Fasan, M., Sinicco, A., Garavelli, P., Ridolfo, A.L., & Vaccher, E. (2000). Lung carcinoma in 36 patients with human immunodeficiency virus infection. The Italian Cooperative Group on AIDS and Tumors. Cancer, 88, 563-569.

2 Benjamin Ryan. Burning Question. HIVPlusMag.com, 2006

3 Gritz, E., Vidrine, D., Lazev, A., Amick III, B., Arduino, R. (2003) Smoking behavior in a low-income multiethnic HIV/AIDS population. Nicotine & Tobacco Research6, 71-77.

4 Jeanne Bell. HIV & the Brain: Still A Problem After Two Decades. Neuropathology Unit, University of Edinburgh, 2007.

5 Tirreli, U., Spina, M., Sandri, S., Serraino, D., Gobitti, C., Fasan, M., Sinicco, A., Garavelli, P., Ridolfo, A.L., & Vaccher, E. (2000). Lung carcinoma in 36 patients with human immunodeficiency virus infection. The Italian Cooperative Group on AIDS and Tumors. Cancer, 88, 563-569.

6 American Lung Association. HIV/AIDS-Related Lung Disease, 2008

7 Philip T. Diaz, Eric R. King, Mark D. Wewers, James E. Gadek, David Neal, Janice Drake and Thomas L. Clanton. HIV Infection Increases Susceptibility to Smoking-Induced Emphysema. Chest, 2000

8 Tamer Alpagot, Nejat Duzgunes, Larry F. Wolff, Aaaron Lee. Risk factors for periodontitis in HIV+ patients. University of the Pacific School of Dentistry, University of California School of Dentistry, San Francisco and University of Minnesota School of Dentistry, USA. 2004

This article previously appeared on the GMFA website here.

Arts and Entertainment Section

Activism Section

  • A bridge to nowhere

    A bridge to nowhere

    Michael Yoder on the Denver Principles and how people living with HIV are doing in relation to GIPA/MIPA and their “nothing about us without us” sentiments.
  • Remembering Joan Rivers, fierce and early voice against AIDS

    Remembering Joan Rivers, fierce and early voice against AIDS

    From TheBody.com comes this tribute to Joan Rivers' work with the HIV community that goes way back. “In a community that is no stranger to grief, the death of an ally like Rivers is hard for many.”
  • The Crescent continues

    The Crescent continues

    What do you do when you’re an AIDS Service Organization and your funding isn’t renewed. You carry on! Here’s more of our continued coverage of how an organization like the UK’s The Crescent is doing just that. Iain Murtagh reports.

Current Affairs Section

Events Section

  • Rob Ford comes in last

    Rob Ford comes in last

    In a PositiveLite.com exclusive, Bob Leahy reports on the pig race that saw Rob Ford come in last this past weekend – right in his own rural community – not once but twice. A sign of things to come, he hopes.
  • The Crescent continues

    The Crescent continues

    What do you do when you’re an AIDS Service Organization and your funding isn’t renewed. You carry on! Here’s more of our continued coverage of how an organization like the UK’s The Crescent is doing just that. Iain Murtagh reports.
  • Throwing cold water on things

    Throwing cold water on things

    Ken Monteith comments on the success of the ALS Ice Bucket Challenge and the lessons we can learn from it about fundraising for HIV-related causes.

Features and Interviews Section

Health Section

International Section

  • Smoking and HIV

    Smoking and HIV

    A UK perspective on smoking and HIV and why, if you smoke, you should probably think about quitting, from GMFA
  • The bottom line

    The bottom line

    UNAIDS asks does the global HIV response understand anal sex?
  • Encouraging vaccine news

    Encouraging vaccine news

    From aidsmap.com, news of a vaccine that has managed to completely block infection with SIV, the monkey equivalent of HIV, in monkeys. This finding gives new hopes for the development of a vaccine which could prevent HIV infection.

Legal Section

Lifestyle Section

Living with HIV Section

Media Section

Opinion Pieces Section

  • The least secret secret

    The least secret secret

    Tom Latte says there is a plague being passed on. No, not HIV. It’s about others sharing our status unasked.
  • The viral divide

    The viral divide

    Strengthening the bonds. Gary Nelson has tough words for those who are divisive - those who think the HIV–negative can’t understand being HIV-positive and those who laud being HIV-negative as superior
  • A bridge to nowhere

    A bridge to nowhere

    Michael Yoder on the Denver Principles and how people living with HIV are doing in relation to GIPA/MIPA and their “nothing about us without us” sentiments.

Population Specific Section

  • The least secret secret

    The least secret secret

    Tom Latte says there is a plague being passed on. No, not HIV. It’s about others sharing our status unasked.
  • The viral divide

    The viral divide

    Strengthening the bonds. Gary Nelson has tough words for those who are divisive - those who think the HIV–negative can’t understand being HIV-positive and those who laud being HIV-negative as superior
  • A bridge to nowhere

    A bridge to nowhere

    Michael Yoder on the Denver Principles and how people living with HIV are doing in relation to GIPA/MIPA and their “nothing about us without us” sentiments.

Sex and Sexuality Section

MarketPlace