How Tobacco Can Be Deadlier Than The HIV Virus

As the global health community makes significant strides toward effectively combating the HIV/AIDS epidemic, HIV-positive individuals are now living longer and healthier lives, largely thanks to advances in treatments for the virus. Research suggests that the virus itself is hardly a death sentence anymore — and, for HIV-positive people, other public health issues are beginning to surpass their HIV status as the biggest threat to their life expectancy.

According to a new study, health complications resulting from smoking — and not from HIV itself — are actually the biggest cause of death among HIV-positive individuals. Researchers tracked HIV-positive people with access to highly active antiretroviral therapies (HAART), the medications that have drastically lowered the rates of HIV-related deaths since they first became available in 1996, and found stark differences between the smokers and non-smokers who received HAART treatment:

In a large case-control study, smokers with HIV had substantially higher rates of all-cause and non-AIDS mortality than HIV-positive nonsmokers, according to Marie Helleberg, MD, of Copenhagen University Hospital, and colleagues. […]

The bottom line, Helleberg said in a statement, is that “more than 60% of deaths among HIV patients are associated with smoking,” compared with slightly more than a quarter associated with HIV.

In the general population, Helleberg and colleagues noted, smoking is one of the major factors that reduce life expectancy.

Among those with HIV, the advent of highly active anti-retroviral therapy (HAART) has meant that lifestyle factors are increasingly affecting survival, while the mortality risk associated with the virus has diminished.

Researchers also noted that HIV-positive individuals are much more likely to smoke than the people who are not infected with the virus, potentially due to stress or socioeconomic factors. In fact, men who have sex with men — the population that remains at the greatest risk for contracting HIV — are themselves more likely to be smokers, both because of minority stress and because Big Tobacco has worked to specifically target LGBT individuals. Anti-smoking activists emphasize that the U.S. should start focusing its smoking cessation campaigns specifically on the LGBT community.

The fact that tobacco could be deadlier than HIV is yet another reason why public health resources need to be invested into anti-smoking programs. But over the past few years, states have been dedicating fewer and fewer funds to anti-tobacco programs, as budget cuts have forced those public health initiatives to be scaled back or ended altogether.