HIV and Smoking in India

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HIV & Smoking in India

There are approximately 2.5 million people living with HIV/AIDS (PLWHA) in India

- the young being particularly vulnerable. The prevalence of smoking has

increased in India especially among rural, lower socio-economic and illiterate

men. Studies have shown that HIV-infected smokers may be at additional risk for

several infectious and non-infectious complications, including malignancies and

cardiovascular events.

Smoking alters immunological mechanisms and suppresses host defenses in the

alveolar environment. HIV-infected smokers have also been found to have a poorer

response

to antiretroviral therapy and a higher risk of death. HIV-infected individuals

who smoke could be at a greater risk for developing TB and subsequently suffer

higher morbidity and mortality than those who do not smoke.

Currently available smoking cessation interventions like physician's advice,

nicotine replacement therapy and pharmacological agents like bupropion and

varenicline have had varying degrees of success. Smoking cessation intervention

in the HIV-infected population might be more complex because of associated

psychosocial problems like drug addiction, alcoholism, depression, etc

..

More research including clinical trials testing the efficacy of smoking

cessation interventions in HIVinfected persons is required in India. In addition

to public health measures like banning smoking in public places and raising

tobacco tax, comprehensive guidelines for health workers can help address this

problem. Counselling on smoking cessation should be one of the main components

of primary care, especially in the management of HIV-infected persons.

This review highlights the importance of smoking cessation among HIV-infected

persons in India.

S. Ramesh Kumar, Soumya Swaminathan, Flanigan*, K.H. Mayer* &

Niaura. HIV & smoking in India. Indian J Med Res 130, July 2009, pp 15-22

A pdf version of this article is available from the following web link

http://www.icmr.nic.in/ijmr/2009/july/0702.pdf