HIV & Smoking

If you have human immunodeficiency virus (HIV) and smoke, you may have questions about smoking, your health, and managing HIV. Quitting smoking is one of the best things you can do for your health. Stopping smoking is especially important for people living with HIV.

How can quitting smoking help me if I have HIV?

Quitting smoking can benefit your health in several important ways. These benefits include:

  • Improving your T-cell count. Non-smokers are more likely to fully control and suppress the virus with their medications than people who smoke. Suppressing the virus to undetectable levels generally leads to rises in the T-cell count.
  • Lowering your health risks. Quitting smoking can reduce many of the health risks that come from smoking.
  • Improving the effectiveness of your HIV medication. Smoking may make anti-retroviral therapy (ART) less effective.

What are the health risks of smoking if I have HIV?

If you smoke and have HIV, you face many serious health risks. These include:

  • Lung infections, including bacterial pneumonia, tuberculosis, and Pneumocystis pneumonia (a fungal pneumonia)
  • Thrush (a mouth infection, also called oral candidiasis)
  • Hairy leukoplakia (white mouth sores)
  • Severe COVID-19
  • Asthma
  • COPD (chronic obstructive pulmonary disease, a serious lung disease that causes severe breathing problems and includes emphysema and chronic bronchitis)
  • Heart disease and stroke
  • Cancer, including lung cancer, cervical cancer, and anal cancer

People with well-controlled HIV who smoke are more likely to die from lung cancer than from HIV. Lung cancer is now a leading cause of death for people with HIV.

What is the effect of smoking on antiretroviral therapy (ART)?

Smoking may make ART less effective. Substances in cigarette smoke may lower the levels of some antiretroviral drugs in your blood.

People with HIV who smoke are more likely to have a worse response to HIV treatment than people who do not smoke.

How can I quit smoking if I have HIV?

Quitting smoking is one of the most important steps you can take to improve your health if you have HIV.

Here are 3 tips to get started:

  • 1. Identify your triggers and create a plan to manage them

    First, think about what makes you want to smoke. These are called triggers. Then, for each trigger, write down how you think you can beat it without smoking. Beating your triggers is a process of experimenting. Some things might work right away, others may not. The most important thing is to keep trying and keep experimenting! You can plan to beat your triggers here.

  • 2. Learn a new way (or two) to manage stress

    Relaxation and stress management strategies can help you feel calm and relaxed. They can help you manage cravings without smoking. Try a few different strategies for managing stress and see which ones you prefer.

  • 3. Talk to your doctor about using medication to help you quit smoking

    Using an FDA-approved medication like varenicline (Chantix®) or nicotine patches, gum, or lozenges can help you quit. They work by making nicotine withdrawal symptoms less intense. They can be used safely in people with HIV, and they don’t interact with most HIV medicines. Medication can double your chances of quitting.

What should I know about using medication to quit smoking if I have HIV?

Food and Drug Administration (FDA)-approved medications are safe and effective ways to help you quit. Medication reduces the intensity of nicotine withdrawal symptoms. Medication can make your quitting journey more comfortable. It can double your chances of quitting for good.

Talk to your healthcare provider before starting any medication to help you quit.

Nicotine Replacement Therapy

One kind of medication is nicotine replacement therapy (NRT). NRT gives you a small and controlled dose of nicotine. NRT includes the nicotine patch, gum, and lozenge. There aren't any known interactions between the nicotine patch, gum, or lozenge and ART.

Medications Without Nicotine

Other medications, including bupropion (Zyban®) and varenicline (Chantix®) don’t have any nicotine. No interactions have been found between varenicline (Chantix®) and ART. Your HIV doctor may not want you to use bupropion (Zyban®) if you are taking high-dose protease inhibitors.

Why should I get support from other people as I quit smoking?

Having people in your life who you can count on to support your quit increases your chances of quitting.

Getting support from others has lots of benefits. It can help you feel less lonely and provide reassurance during difficult times. It can motivate you on your quitting journey. And it can help you see the bigger picture of why you want to quit.

Many people can support you. They can be close to you or just an acquaintance. They might include:

  • Family members
  • Your spouse or partner
  • A healthcare provider, like a doctor or therapist
  • Other professionals, like a social worker or a religious leader
  • The EX Community

The EX Community is the longest-running and largest online community for people quitting smoking, vaping, and tobacco. Research shows that using the EX Community helps people quit. Learn more about how to use the EX Community.

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