Smoking

Smoking helpline: 0800 169 0169

Smoking is the biggest avoidable cause of death and illness in the UK. More than 120,000 people a year die from diseases caused by smoking. Apart from being expensive for the consumer smoking is very expensive for the nation, costing the NHS and taxpayer up to 1.5 billion every year.

Tobacco in cigarettes, cigars and pipe tobacco contains poisons such as ammonia, acetone, carbon monoxide, cyanide and arsenic. Altogether cigarettes can often contain 4000 chemicals.

HIV-positive smokers may be more likely to get certain AIDS-defining illnesses if they have a weak immune system, and be at increased risk of developing the metabolic sideeffects caused by some anti-HIV drugs.

Smoking and HIV
Smoking in itself does not make HIV infection worse. The rate at which HIV disease progresses or the number of CD4 cells which are lost is no greater in smokers than nonsmokers. Anti-HIV medication is just as effective in smokers as non-smokers.

However, there is evidence that smokers with HIV are more likely to get certain infections, particularly those affecting the chest. Smokers are approximately three times more likely than non-smokers to develop AIDS-defining pneumoncystis carinii pneumonia (PCP); and more likely to develop oral thrush.

Smoking causes premature ageing of the central face area.

Emphysema, a lung condition which makes you very short of breath, occurs much more commonly in HIV-positive smokers than HIV-negative smokers.

Smoking increases the risk of heart disease, high blood pressure, and stroke. It is thought that a long-term illness like HIV might increase the risk of heart disease. Some anti-HIV medication can cause increase in blood fats, which can contribute to cardiovascular diseases. The risks are therefore further increased in smokers who take anti-HIV medication.

Smoking also increases the risk of lung cancer. Lung cancer seems to occur more often in people with HIV, even if they are taking anti-HIV medication and have a wellcontrolled viral load. In one study, all the HIV-positive people who developed lung cancer were smokers.

Stopping smoking
Stopping smoking will significantly reduce your risk of developing heart disease and other cardiovascular diseases. You are most likely to stop smoking and stay stopped if you are motivated

There is now a comprehensive NHS Stop Smoking Service offering support and help to smokers wanting to stop. Nicotine Replacement Therapy (NRT) and bupropion (Zyban) are available on NHS prescription. Services are provided in group sessions or one to one, and most stop smoking advisers are nurses or pharmacists, who have all received training for their role.

Nicotine Replacement Therapy (NRT)
Cigarettes contain nicotine which is addictive. NRT can help reduce the craving for cigarettes and make quitting easier. Patches, gum, or lozenges that contain nicotine are available as prescription and over-the counter. There is no evidence that these interact with anti-HIV medication.

Bupropion (Zyban)
The antidepressant drug bupropion (Zyban) has been licensed to help people to stop smoking. However, it is important that individuals with HIV who are considering to take this drug to consult their doctor. The drug interacts with anti-HIV medication of both the protease inhibitor and NNRTI classes, leading to an increased amount of bupropion in the blood. Associated side-effects include dry mouth, insomnia, headaches, and fits.

Complimentary therapy
Complimentary therapies such as acupuncture and hypnotherapy may help individuals to stop smoking. Exercise is also helpful.

Useful support and helplines:
* NHS Smoking helpline: 0800 169 0 169, website: www.nhsdirect.nhs.uk
* Quitline: 0800 002200, website: www.quit.org.uk
* www.metromate.org.uk – Gay Stop Smoking Group
* Smoking Cessation Clinic – 0800 085 9147 provided by Kensington and Chelsea PCT. Available to anyone who lives or works in Kensington and Chelsea.