by J. Edward Casteele

Created on: July 07, 2009

Cigarettes are considered by many to be one of the greatest scourges facing society today. They have a number of negative health connotations, and many communities have begun the process of banning smoking in a number of public areas to help reduce the dangers of secondhand smoke. Given the association that cigarettes have with lung infections, cancers, and other health concerns, you might be surprised to learn how many HIV-positive individuals smoke on a regular basis.

The smoking of cigarettes in HIV-positive populations tends to be a heated issue; individuals on both sides of the debate are willing to make their opinions loudly known. Anti-smoking lobbyists claim that smoking cigarettes is only going to result in a much earlier death from opportunistic infection. HIV-positive smokers claim that smoking has no effect on CD4 counts or the effectiveness of their medications, making it no more dangerous for them than for any other smoker. While it is a matter of medical fact that smoking can be detrimental to an individual's health, some individuals with HIV still manage to find the silver lining around a cloud of cigarette smoke.

The negatives of smoking cigarettes have the potential to cause even more problems for HIV-positive individuals than standard smokers. Smoking can depress the immune system, making it easier for opportunistic infections to set in; HIV-positive populations know the dangers of these infections, since even a relatively minor infection can result in serious complications. Cigarette smoke also increases the likelihood of lung cancer and other lung disorders, and the depressed immune system of an individual with HIV may not be able to combat these diseases or even cope with treatment nearly as well as other smokers. Even the reduction of appetite that smoking can cause is a potential problem for HIV-positive individuals, since many people with advanced HIV or AIDS have serious problems with appetite already and smoking can increase this dramatically.

With all of these negatives, one might wonder why anyone with HIV would even consider smoking. For many HIV-positive individuals, however, smoking actually becomes somewhat of a life-affirming experience. Even though they are aware of the negative aspects of smoking cigarettes, being able to defy logic with a cigarette can help the HIV-positive smoker to feel more in control of their life and their destiny. Cigarettes don't interfere with most antiretroviral medications that are prescribed to control HIV, so positive smokers aren't putting themselves at too much of an increased risk of their infection escalating. Likewise, smoking cigarettes doesn't seem to have a profound impact on CD4 count. It can be easy to rationalize smoking because it isn't doing significant harm in regards to the HIV infection itself, and when facing a disease that is as potentially severe as HIV and AIDS it can be important for individuals to allow themselves at least a few vices.

To get the maximum health benefit, quitting smoking is an obvious choice for HIV-positive individuals. It should be taken into consideration that it is a relatively complex issue, however, and that the smoker is the one who ultimately has to make up their mind as to whether they will continue smoking or not. Facing nicotine withdrawal and kicking the habit can be difficult for anyone, and adding HIV concerns about illness to it doesn't make the process any easier. Medical professionals may be able to offer assistance in overcoming nicotine addiction for those HIV-positive smokers who wish to quit but are unable to do so on their own.

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