Smoking & Tobacco Use
HIV AND Smoking
Tobacco use is the leading cause of preventable illness and death in the United States, causing nearly one out of five deaths in the United States each year.
Smoking increases your risk of developing lung cancer and other cancers, heart disease, chronic obstructive pulmonary disease (COPD), asthma, and other diseases, and of dying early.
For these reasons, smoking is a significant health issue for all individuals, but it is even more of a concern for people living with HIV, who tend to smoke more than the general population. According to the U.S. Centers for Disease Control and Prevention (CDC), approximately 19% of adults in the United States are smokers. However, the smoking rate is two to three times higher among adults who are HIV-positive.
In addition, smoking has many negative health effects on people who are HIV-positive. For example, smokers with HIV:
- Are at higher risk than non-smokers with HIV of developing lung cancer, head and neck cancers, cervical and anal cancers, and other cancers;
- Are more likely than non-smokers with HIV to develop bacterial pneumonia, Pneumocystis jiroveci pneumonia (PCP), COPD, and heart disease;
- Are more likely than non-smokers with HIV to develop two conditions that affect the mouth: oral candidiasis (thrush) and oral hairy leukoplakia; and
- Have a poorer response to antiretroviral therapy.
People with HIV who smoke are also less likely to keep to their HIV treatment plan and have a greater likelihood of developing an AIDS-defining condition and dying earlier than non-smokers with HIV.
For more information on how smoking affects people living with HIV, see the HRSA Guide for HIV/AIDS Clinical Care: Smoking Cessation and the U.S. Department of Veterans Affairs’ (VA) HIV Patient and Provider Smoking Cessation Resources.
The Benefits of quitting smoking
Quitting smoking has major and immediate health benefits for all tobacco users, including those living with HIV/AIDS. Quitting smoking decreases your risk of lung cancer and other cancers, heart disease, COPD, and stroke.
Smokers with HIV also experience a decrease in HIV-related symptoms and an improved quality of life after quitting.
For more information on the many health benefits of quitting smoking, visit betobaccofree.hhs.gov.
The Role of healthcare providers
Surveys have found that two-thirds of smokers living with HIV/AIDS want to quit smoking. Healthcare providers can play an important role in encouraging and supporting them.
Healthcare providers who talk to their patients about quitting smoking—even for just 3 minutes or less—can have a positive impact on those smokers’ decision to quit.
In fact, in a large-scale study of thousands of people with HIV, researchers concluded that smoking represented such a significant risk factor for developing serious clinical diseases and death that healthcare providers should routinely make “stop smoking” programs part of the HIV care they provide.
For tips and tools to assist people with HIV who are seeking to quit smoking, healthcare providers may wish to refer to the HRSA Guide for HIV/AIDS Clinical Care: Smoking Cessation or the VA’s HIV Provider Smoking Cessation Handbook.
help to quit smoking
The Affordable Care Act offers several resources to help people quit smoking. Under the Affordable Care Act, private health insurance policies created after March 23, 2010 are required to cover recommended preventive health services at no extra cost to the consumer. This includes tobacco use screenings for all adults and cessation interventions for tobacco users.
The Act also provides for Medicaid coverage of tobacco cessation services for pregnant women, at no extra cost, along with expanded Medicare coverage of tobacco cessation counseling, making it available to approximately 5 million Medicare tobacco users—not just those with tobacco-related diseases.
In addition, the Affordable Care Act expands employment-based wellness programs, such as those that focus on helping employees stop smoking.
Learn more about preventive care covered under the Affordable Care Act.
The Federal Government also has several other resources to assist individuals in quitting smoking:
- Smartphone Apps—The National Institutes of Health (NIH) has launched QuitPal, a free smartphone app to help smokers change their behavior. Also, the VA has developed the StayQuit Coach app to help individuals stay quit after they have stopped smoking.
- Tips from Former Smokers—The CDC offers "Tips from Former Smokers,” featuring people discussing the health effects they are living with as a result of their tobacco use, as well as resources and tools to help individuals quit smoking.
- Information and Resources—The website, BeTobaccoFree.hhs.gov, provides information on avoiding or ending tobacco use.
- Chat/Phone Support—The National Cancer Institute’s (NCI) Smokefree.gov provides free resources to help people quit smoking, including real-time live instant messaging help from a counselor. You can also call 1-800-QUIT-NOW for free quit coaching and referrals to local resources.
- Help for the Military—The U.S. Department of Defense (DOD) website, Quit Tobacco. Make Everyone Proud, offers resources for members of the U.S. military and their families.
Related Topics on AIDS.gov
Frequently Asked Questions
I’m thinking about quitting, but even just thinking about it is making me anxious. What should I do?
Quitting works best when you’re prepared. Before you quit‚ START by taking these five important steps:
S = Set a quit date.
T = Tell family‚ friends‚ and coworkers that you plan to quit.
A = Anticipate and plan for the challenges you’ll face while quitting.
R = Remove cigarettes and other tobacco products from your home‚ car‚ and work.
T = Talk to your doctor about getting help to quit.
For more information, visit smokefree.gov.
- U.S. Surgeon General – Tobacco Initiative
- HHS – Tobacco Control and Prevention Initiative
- CDC – Office on Smoking and Health
- VA – Tobacco and Health
- VA – HIV Provider Smoking Cessation Handbook
- VA – My Smoking Cessation Workbook: A Resource for Patients
- FDA – Smoking Cessation Products
- AIDSInfoNet – Smoking and HIV
- American Heart Association – HIV and Smoking
Last revised: 07/05/2013