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Smoking and HIV


If you have HIV, are on treatment and smoke, your risk of death is doubled.

Cigarettes contain over 4,000 chemicals, around 50 of which cause cancer. These include carbon monoxide, which reduces the oxygen levels in your blood so that not enough oxygen is delivered to the organs and your energy levels drop.

Smokers become addicted to the nicotine in cigarettes, which is why you experience cravings and withdrawal symptoms when you stop smoking.

Smoking affects your blood pressure, fertility, your skin, teeth and lungs, and increases your risk of cancer, heart disease and stroke.

Does smoking cause worse problems for people with HIV?

Yes. According to a recent study, if you have HIV, are on treatment and smoke, your risk of death is doubled.

On the other hand, non smokers with HIV who are doing well on treatment can expect to have a normal lifespan. You can read more about the study here.

Another study from Denmark has recently reported that the rate of heart attacks among smokers with HIV is three times higher than that of HIV negative smokers. You can read more about the study on Aidsmap.

Smoking rates are higher among people living with HIV. HIV itself causes changes to the cholesterol, which can cause or hasten cardiovascular disease. In addition, certain antiretrovirals also have a negative effect on cholesterol and lipids. If you add smoking to the mix, the risks are greater.

These findings show how important it is to try to stop smoking so that you have as good a chance as possible of leading a normal lifespan. It can be difficult to stop but there is lots of free help and support.

Are you more likely to smoke if you have HIV?

New American research, published in AIDS, has found that rates of ‘modifiable risks of cancer’ were higher in HIV positive people.

Modifiable risks are factors over which we have some control, such as:

  • smoking,
  • drinking,
  • infection with HPV and
  • hepatitis B and C.

The study found that in people living with HIV, these modifiable risks occur at higher rates than in the general population. As much as 54% of the HIV positive participants included in the study were smokers – a proportion around two-and-a-half times higher than in the general American population.

How can I stop smoking?

Some people use nicotine replacement products to help them stop. These can come in the form of patches, lozenges, gum, inhalers and inhalators and you can gradually reduce the amount you take until the cravings pass.

Your doctor can prescribe you nicotine replacement therapy. There are also medicines you can take to help with your cravings - one of these is called varenicline (Champix). A recent French study into smoking cessation among HIV positive people found that it had a much higher success rate than a placebo in helping people to stop. However, less than 20 per cent of study participants were able to stop smoking for more than a year and Champix can have side effects such as depression. Read more about this study.

Every area has a local NHS service to help you stop smoking. As well as nicotine replacement therapy, they also provide group or one-to-one support. There is also a national helpline. You can find out more at Smoke Free.

Should I try vaping?

e-cigarettes: many people have found using e-cigarettes (vaping) helps them quit smoking. Although e-cigarettes can contain nicotine, which is addictive, they don’t contain all the toxins found in cigarette smoke that cause cancer and heart disease.

The NHS advises that e-cigarettes are less bad for you than smoking cigarettes but points out that there is still debate about whether or not the chemicals in e-cigarettes are bad for you. At the moment there hasn’t been a large-scale study into their effects. You can read more here.

Extra support with quitting:

Smokefree is an NHS website with lots of advice and information about quitting.

You can call their helpline on: 0300 123 1044. It is open from Monday to Friday from 9am to 8pm, Saturday and Sunday from 11am to 4pm.

You can also chat to one of their advisers online.



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The Information Standard: Certified member

This article was last reviewed on 6/4/2016 by Anna Peters

Date due for the next review: 6/4/2019

Content Author: Kerri Virani

Current Owner: Health promotion

More information:

High rates of modifiable cancer risk factors present in Western HIV positive patients , by Michael Carter, NAM Aidsmap, January 2016

Smoke Free, NHS

Smoking, Michael Carter, NAM aidsmap, April 2011

Smoking and HIV, AIDS InfoNet, August 2014

Clearing the air on the hard facts of what smoking does to your body, Smoking Cessation (2005)

What smoking does to your body, NiQuitin (2011)

Frequently Asked Questions, (click on ‘What does smoking do to my body’ and ‘Nicotine Replacement Products and other stop smoking medicines’), NHS Smokefree

Stopping smoking – the benefits and aids to quitting, ASH factsheet, September 2014

What happens when you quit?, NHS Smokefree

What are the health risks of smoking?, NHS Choices, November 2013

Why is smoking addictive?, NHS Choices, December 2013

Nicotine and addiction, ASH factsheet, June 2013

Smoking doubles risk of death for patients taking HIV therapy, Michael Carter, NAM aidsmap, December 2014

Smoking is the main cause of increased risk of heart attack in people with HIV, Roger Pebody, NAM aidsmap, January 2015

Real-world effectiveness of e-cigarettes when used to aid smoking cessation: a cross-sectional population study, Jamie Brown1,2,*, Emma Beard1, Daniel Kotz1,3, Susan Michie2,4 andRobert West1,4 Article first published online: 8 AUG 2014 DOI: 10.1111/add.12623

Varenicline helps people with HIV stop smoking, but success rate remains low, Liz Highleyman, produced in collaboration with hivandhepatitis.com, NAM aidsmap, March 2015