Some say that personal testimony is the best persuader of all. Certainly the HIV community has used the technique for years, sending people living with HIV out in the community to talk to others about the experience of living with HIV. Sometimes it’s intended as a deterrent to others to go down that path, although I’ve always preferred an approach which stresses our normality and encourages others to talk openly about HIV. (I never liked to be thought of as "Exhibit A" though.)
We’ve been less successful, perhaps at talking to each other about issues related to our own health and wellness,. Nowhere has this been more apparent than in the area of tobacco consumption, a habit which can quickly and dramatically undo the hard-earned benefits of taking antiretroviral therapies and have disastrous consequences on what researchers call "morbidity, mortality and health-related quality of life". We are talking well proven reduced life expectancy, more time spent sick and reduction in a range of factors which measure how happy, successful and content we are.
But quitting isn’t easy. Tobacco is an addiction, notorious for being as hard as any to shake, and it takes strong will and (usually) multiple attempts to quit. Only in recent years has the HIV community got on side in recognizing the barrier that nicotine represents to healthy living and made baby steps to help HIV-positive smokers who want to quit actually do so. In Ontario, for example, PositiveLite.com has championed, and in fact the writer co-chairs, Positive Quitting, jointly with the Ontario HIV Treatment Network (OHTN), which offers smoking cessation alternatives to people living with HIV, or at least points them in the right direction.
The OHTN’s Sean Rourke (left) sees great potential in this project. “We want to help people to make healthy choices” he says. ”I’m not sure it's taboo” he says “but (PHA smoking) Is something that people just don’t talk about. We just need to get it out in the open. I think a lot of people want to stop smoking but they don’t know how or don’t have the resources to do so and our job is to connect them into those resources and those opportunities to help them make healthier choices.”
Adds Sean “This is something very dear to our heart at the OHTN in providing the evidence for this, and it’s part of a wider strategy here in Ontario that will improve the health and wellbeing of people living with HIV.”
The need to give smokers a helping hand is particularly apparent given high smoking rates in the HIV community in Ontario, which hover in the 40% range, almost twice that of the general population. The good news is that these rates are on the decline as smoking becomes less acceptable (who wants more stigma?), the price of cigarettes rises beyond reach and people become more health conscious generally.
In the US, the CDC estimates from 2009 suggest that 42 percent of HIV-positive people smoke, compared with about 20 percent of the general U.S. population also.
Brian is a former HIV-positives smoker currently appearing on video (see below) speaking up about the negative impact smoking has had on his own health since being diagnosed. Part of the CDC’s Tips from Former Smokers campaign, the video is described thus “Smoking is especially dangerous for people who are living with HIV, the virus that can cause AIDS. Brian learned that lesson the hard way, when he had a stroke—a brain attack—at age 43. Over time, smoking and having HIV had led to clogged blood vessels in Brian's neck. In this video from CDC's Tips From Former Smokers campaign, Brian talks about surviving HIV-related medical problems. He regained good health—then nearly lost his life because of smoking”.
We know from HIV prevention research at least that scare techniques don’t always work. It is sometimes more constructive, for instance, to focus on the health benefits that recently quit smokers can expect to experience. Thus should we more effectively highlight the message that smoking cessation advocates tell us – giving up smoking is THE best thing that we poz folk can do for our health? You be the judge. But perhaps, as with HIV prevention, a variety of techniques works. Different strokes for different folks. (Notice how the video uses both approaches - warning of the dangers of smoking while also stressing that stopping smoking will be your greatest achievement.")
In any event, watch the video and see what you think. Meanwhile PositiveLite.com will continue to provide coverage of efforts to reduce smoking rates in people living with HIV. Next time: resources that can help HIV-positive smokers to quit – and methods from chemical assistance to cold turkey.
That last one, believe it or not, worked for me by the way. But only after multiple attempts to get there. I’d like to explore in future columns what might work for you.