Why Smoking Is So Dangerous for People with HIV

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Breathing smoke out

Study after study has shown that smoking is bad for your health, but for those who are HIV-positive, it is even more harmful. If you have HIV (human immunodeficiency virus) and you smoke, you are more susceptible to opportunistic infections—caused by microbes that take advantage of a weakened immune system or other abnormal condition. One of the most serious risks is lung infections and diseases since smoking is detrimental to lung function. Additionally, HIV antiretroviral therapy often doesn’t work as well for people who smoke, and smoking typically shortens the lifespan of people with HIV.

HIV treatment has improved so much in recent years and people with HIV are living healthier and longer lives. If you are HIV positive and you smoke, stopping smoking will help you live your life to the fullest.

How Smoking Affects People with HIV

In addition to HIV medications not working as well, smoking with HIV also increases the risk of many different health problems. Because people with HIV have weakened immune systems, they are less able than healthy people who smoke to fight off disease, particularly lung disease. HIV-positive smokers have a higher chance of developing an AIDS-defining illness. This means that someone who has one or more of these illnesses can be diagnosed with AIDS (acquired immune deficiency syndrome), the most advanced stage of HIV.

Health problems for HIV-positive smokers include:

A weakened immune system also puts people with HIV at risk for opportunistic infections, and those who smoke are at even higher risk for such illnesses. These infections include:

  • Lung infections, such as bacterial pneumonia or pneumocystis pneumonia. Pneumocystis pneumonia is caused by a fungus that lives in the lungs; it is an AIDS-defining illness. Signs of pneumonia include cough with mucus (phlegm), fever, chills, or shortness of breath with light activity.

  • Mouth infections, such as oral thrush or hairy leukoplakia, which causes white sores to form in the mouth. Signs of thrush include creamy white lesions on the tongue or inner cheek, burning sensation that may cause difficulty swallowing, and cracking at the corners of the mouth.

How You Can Kick the Habit

People with HIV tend to smoke at higher rates than healthy people, but quitting can improve your quality of life and reduce your risk for smoking-related diseases. This includes smoking tobacco as well as marijuana.

There are several ways to kick the habit of smoking. Some people quit “cold turkey,” meaning they stop smoking with no medicinal or social support. Others may use medications to reduce the symptoms of withdrawal, or they may seek counseling or support groups to deal with their addiction. Medications include over-the-counter gum, lozenges or patches to reduce cravings. Your doctor can prescribe other smoking cessation medicines to help you quit. Talk with your doctor about the potential side effects of these prescription drugs.

Other tips to help you quit include changing your routines to avoid situations when you normally would smoke. Find ways to reduce stress and anxiety, which may give some people the urge to smoke. Rather than lighting up, find other ways to relax. You can also join a support group with other people on the same journey to increase accountability. Complementary treatments, such as acupuncture or hypnosis, may also help some people quit smoking.

Although quitting is difficult, it is possible. Take it one day at time, and keep looking forward. The improvement in your health, well-being, and quality of life will be worth the effort.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Sep 8
  1. Smoking and HIV. Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/campaign/tips/diseases/smoking-and-hiv.html
  2. Smoking and HIV. HIV.gov. https://www.hiv.gov/hiv-basics/staying-in-hiv-care/other-related-health-issues/smoking
  3. Smoking and HIV. AIDS InfoNet. http://www.aidsinfonet.org/fact_sheets/view/803
  4. Smoking and Tobacco Use. The Well Project. http://www.thewellproject.org/hiv-information/smoking-and-tobacco-use
  5. COPD. MedlinePlus, U.S. National Library of Medicine. https://medlineplus.gov/copd.html
  6. Pneumocystis Infections. MedlinePlus, U.S. National Library of Medicine. https://medlineplus.gov/pneumocystisinfections.html
  7. AIDS-defining illnesses. U.S. Department of Veterans Affairs. https://www.hiv.va.gov/patient/diagnosis/OI-AIDS-defining-illnesses.asp
  8. Pneumonia Symptoms, Causes, and Risk Factors. American Lung Association. http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/pneumonia/symptoms-causes-and-risk.html
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