Cigarette Smoking and HIV: More Evidence for Action

Abstract

As many as 50–70% of persons infected with HIV are current smokers. Compelling evidence concerning the risks of cigarette smoking to persons living with HIV urges the inclusion of smoking treatment protocols in contemporary models of HIV care. Yet in spite of growing awareness of this problem, persons living with HIV are not being effectively treated for tobacco use. To further an understanding of contributing factors and define directions for evidenced-based intervention, factors associated with smoking behavior among persons living with HIV are examined.

Smoking, HIV Status, and HIV Risk Behaviors in a Respondent-Driven Sample of Injection Drug Users in Baltimore, Maryland: The BeSure Study

“…Positive associations between heavy cigarette smoking and non-injected heroin, crack use, painkiller use, and binge drinking in the past year among IDU in our study echo research on the cooccurrence and reinforcement of tobacco and polysubstance use (Reynolds, 2009;Substance Abuse and Mental Health Services Administration, 2009). Results like ours may provide insight into the spectrum of addiction among IDU and guidance on the targeting of drug treatment and HIV prevention interventions for IDU.…”

“…Widely implemented tobacco cessation programs have had a rapid population benefit (Land et al, 2010), and recent calls for smoking cessation treatment among HIV-positive individuals (Hoffman, Starks, & Gritz, 2009;Nahvi & Cooperman, 2009;Niaura, et al, 2000;Reynolds, 2009) support the need for upstream smoking interventions tailored to those at greatest risk of contracting HIV. Research also indicates that the concurrent treatment of drug co-dependencies is more effective in reducing relapse (Hurt & Patten, 2003;Reynolds, 2009).…”

“…Widely implemented tobacco cessation programs have had a rapid population benefit (Land et al, 2010), and recent calls for smoking cessation treatment among HIV-positive individuals (Hoffman, Starks, & Gritz, 2009;Nahvi & Cooperman, 2009;Niaura, et al, 2000;Reynolds, 2009) support the need for upstream smoking interventions tailored to those at greatest risk of contracting HIV. Research also indicates that the concurrent treatment of drug co-dependencies is more effective in reducing relapse (Hurt & Patten, 2003;Reynolds, 2009). This is borne out in longitudinal studies of drug-using behavior in Baltimore IDU which showed that current cigarette smoking was negatively associated with cessation of injection drug use (Galai, Safaeian, Vlahov, Bolotin, & Celentano, 2003) and abstinence from smoking and alcohol reduced time to cessation of injection drug use (Shah, Galai, Celentano, Vlahov, & Strathdee, 2006).…”

“…Current smoking is also associated with increased all-cause mortality compared to non-smoking in persons living with HIV/AIDS (Pines, Koutsky, & Buskin, 2011). As treatment improves and HIV is managed as a chronic disease (Siegel & Lekas, 2002;Vidrine, 2009), there is an increasing need to target smoking cessation services to those with HIV and those at greatest risk for HIV (Benard et al, 2007;Niaura et al, 2000;Reynolds, 2009).…”

“…Studies have posited a gateway theory of drug use, whereby use of licit substances like cigarettes and alcohol progresses to initiation of marijuana, illicit drugs, and prescribed psychoactives (Chen & Kandel, 1995;Kandel & Logan, 1984;Yamaguchi & Kandel, 1984). In the transition to illicit drug use, including injected drugs, patterns of polydrug use emerge and cigarette smoking remains highly prevalent (Reynolds, 2009;Substance Abuse and Mental Health Services Administration, 2009). In a 1997 national study of drug use, 71% of recent illicit drug users had smoked cigarettes in the past month (Richter, Ahluwalia, Mosier, Nazir, & Ahluwalia, 2002).…”