Smoking: It Doesn't Make Living with HIV Any Easier

Recent research has examined whether cigarette smoking speeds progression to AIDS.

Studies have shown that HIV-positive smokers are more likely to develop Pneumocystis carinii pneumonia (PCP) and develop PCP more quickly than non-smokers. These results should come as no surprise, since smoking impairs the lungs, making them more vulnerable to infection.

Studies have also found that cigarette smoking significantly increases the likelihood and rate of developing thrush (mouth sores), oral hairy leukoplakia (whitish sore on the side of the tongue and inside cheeks) and bacterial pneumonia in smokers with HIV. The bacteria that causes Mycobacterium avium complex (MAC), a life-threatening infection affecting as many as 40 percent of people with HIV) not only was recovered from the tobacco, cigarette paper and filters of four major brands of cigarettes but even survives the smoking process.

We know that smoking is, in general, damaging to one's health. For people with HIV who are trying to reduce their risk of exposure to bacteria, this research provides another reason to kick the habit.

Keep in mind that secondhand smoke involuntarily inhaled by non-smokers from other people's cigarettes is classified by the U.S. Environmental Protection Agency as a known human (Group A) carcinogen, responsible for approximately 3,000 lung cancer deaths annually in U.S. non-smokers.

Better Off Smoke-Free

Some people with HIV are convinced that their viral load and CD4 counts would not be as good without taking the difficult steps to stop smoking. Anti-HIV drugs do just so much, so the rest is up to you.

If you are HIV-infected and smoke, you might want to set a goal of changing your lifestyle over the next year. It's important for people with HIV who want to stop smoking to be in a safe and supportive environment where they are empowered to give up cigarettes on their own terms. For those not ready to quit altogether, experts recommend cutting the amount and frequency of smoking.

At First if You Don't Succeed

Ex-smokers will usually tell you it takes three to four attempts before successfully quitting smoking.

More than 3 million Americans quit smoking permanently every year. And you can, too! Don't despair, even if you have tried and failed in the past. By choosing the right approach and keeping a positive attitude, you'll see that there is still hope to kick the habit.

Some people are successful quitting "cold turkey," while others slowly decrease the number of cigarettes per day until they quit. Some even need the assistance of medical professionals. Choose the method that best suits you and your lifestyle.

Nicotine addiction is 95-percent psychological and about 5-percent physiological. No one ever died of nicotine withdrawal. In fact, most people make it through the withdrawal symptoms but start smoking again due to boredom, stress or peer pressure.

Since nicotine is eliminated from the body in two weeks, the "pressures" you feel to start again aren't from the nicotine, they're from the psychological stressors in your life.

Help is Available

Many resources for helping smokers quit are available.

Most resources can be categorized as either smoking cessation programs or methods used to treat withdrawal from nicotine. By offering ongoing counseling and coping strategies that help with the psychological stressors that are often the reasons for relapse, a formal smoking cessation class increases your chances of quitting tremendously.

Methods used to treat nicotine withdrawal, such as gums, patches, inhalers, nasal sprays and medications, alleviate the symptoms of withdrawal only. While acupuncture, hypnosis and biofeedback work for some, there is no formal evaluation validating their success rates.

Get Informed

A wealth of information about smoking cessation is available for those contemplating taking that step.

The American Lung Association can be reached be calling (800) LUNG-USA (1-800-586-4872), or by visiting http://www.lungusa.org. Also, check with your local chapters of the American Heart Association and the American Cancer Society for tips, programs and other helpful information.

The American Lung Association offers a smoking cessation program called 1999 Freedom from Smoking Clinics. The program is conducted by ALA-trained and certified instructors who have a background in health education, teaching, psychology, and medicine, or who have quit successfully themselves through the program and want to help others.

Visit http://www.lalung.org/what/freedom.html for a list of clinics in L.A. County. You can also check with your health care provider for smoking cessation programs they might offer.

TIPS on Smoking Cessation

• Talk with your health-care provider about how to stop smoking. You'll most likely be asked questions to help best determine the method that will work for you. You can also ask your doctor about a prescription for the nicotine patch to decrease cravings.

• Make the commitment. It's not about willpower. Get support.

• Change your daily routine. If you smoke with your coffee in the morning, change to tea or another beverage.

• Keep a logbook or diary of your smoking habits such as how you felt, the time of day, and what you were doing and review it with your healthcare provider.

• Make rules. No smoking in the car, for one (and remove the ashtray and lighter), no smoking in the house, and buy only one pack at a time. Getting to the commitment is the hardest part. After accomplishing this feat, don't go it alone. Take advantage of help that's available.

• Do not try to quit when stress is already high. Actively use stress-reduction techniques to help you handle this period. Stress-reduction techniques include exercise, massage, safer sex and bubble baths. Drink lots of water and fruit juices or herbal tea to flush out your system. Reward yourself by reinvesting drug, alcohol, or cigarette money on healthy or favorite foods or relaxing activities. Deep breathing (while visualizing the toxins leaving your body as you exhale) can help send a powerful message to your immune system.

10 Excellent Reasons to Quit

• Smoking gets you into trouble in restaurants, airports, planes and people's homes.

• Smoking makes you unattractive to others and consequently, it's more difficult to get a date.

• Smoking is expensive. At $3 a pack, smoking a pack a day each week equals $21 or $1,092 a year.

• Smoking can increase your health insurance premiums.

• Smoking can cause poor dental hygiene including tooth loss.

• Smoking can cause emphysema, lung cancer and has been linked to almost all other cancers, glaucoma, heart disease and stroke.

• Smoking can accelerate osteoporosis (weakening of bone tissue).

• Smoking causes secondhand smoke which can harm those living with you.

• Smoking is the leading cause of most preventable deaths in the U.S.

• Smoking can kill you.

Nancy Wongvipat is a health education specialist in AIDS Project Los Angeles' Education Division. She can be reached by calling (323) 993-1511 or by e-mail at nwongvipat@apla.org.