There is no question that long-term smoking is dangerous: not just for lungs due to shortness of breath and cancer, but also increased risk of cardiovascular disease. One in four deaths in the U.S. among people living with HIV are smoking related. Unfortunately, the frequency of smoking is much higher among people living with HIV as well. This study used information from National Health and Nutrition Examination Survey to determine that between 1999 and 2016, 47% of people living with HIV were current smokers compared to about 26% of those without HIV. The HIV patients in the survey were more likely to be older, male, and non-Hispanic Black, with substance use and depression being more common among them as well.
Obviously, smoking is a major problem for older persons with HIV that needs to be addressed. There are various approaches available for treatment of chronic smoking. Examples include Nicotine replacement therapy such as a patch, gum, lozenge, inhaler, and nasal spray. However, there must be simultaneous attention paid to depression (about 51% of people living with HIV in this study indicated symptoms of mild depression) and drug addiction (34% indicated heavy alcohol use and 54% indicated using cocaine, heroin, or methamphetamine) to increase the likelihood of success. Talk to your primary care team for help if you think you are experiencing depressive symptoms, such as feeling down and blue for extended periods. Also, the dangers of drug addiction are well known and finally addressing this major problem will have lasting benefit beyond smoking cessation. Medical care teams should be aware of these underlying issues when addressing smoking problems and probe for the presence of depression and drug addiction. Progress is possible in this area, but there is also a need for the community to increase resources and efforts to be successful in reducing the smoking rate in older adults living with HIV.
Asfar, T., et al. (2021). “National Estimates of Prevalence, Time-Trend, and Correlates of Smoking in US People Living with HIV (NHANES 1999-2016).” Nicotine Tob Res.