Dangers of Smoking Greatly Enhanced for HIV-Infected Patients, Study Finds

David Wohl, M.D.

You are more likely to convince HIV-infected smokers to use condoms, take HIV meds faithfully and even abstain from their beloved Mountain Dew than do battle with their tobacco addiction. A recently published study from a national cohort of HIV-infected Danes supplies a bunch of new facts that you can use to scare -- er, counsel -- your patients afflicted with tobaccoism:

• Increased risk of dying for an HIV-infected smoker compared to an HIV+ nonsmoker: 4 times
• Life expectancy of a 35 year old HIV-infected patient who smokes: 62 years
• Life expectancy of a 35 year old HIV-infected patient who never smoked: 78 years
• Total years lost due to smoking: 12.3 (!)

But we also must do our part by setting such patients up for success. Facts alone won't do it, and we need to be recommending evidence-based smoking cessation interventions (such as those recommended by the U.S. Centers for Disease Control and Prevention, or those explored by Rafael Laniado-Laborin in a 2010 study). Other than prescribe antiretroviral therapy, it just may be the most life-saving thing we do for our patients.

The Study: Helleberg M, Afzal S, Kronborg G, et al. Mortality Attributable to Smoking Among HIV-1–Infected Individuals: A Nationwide, Population-Based Cohort Study. Clin Infect Dis. 2013; 56(5): 727-734.

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