Smoking and HIV

Content From: HIV.govUpdated: January 26, 20245 min read


Living healthy with HIV includes living a tobacco-free life.

How Does Smoking Affect People with HIV?

Tobacco smoking causes serious health consequences. It harms nearly every organ of the body, causes many diseases, and reduces the health of smokers in general. These health risks are high for all smokers, but particularly for people with HIV, who smoke at about twice the rate of the general population.

Smoking is linked to multiple medical problems among people with HIV, including:

  • Lung cancer and other non-AIDS-defining cancers.
  • Cardiovascular (heart) disease.
  • Pulmonary (lung) infections.
  • Chronic obstructive pulmonary disease (COPD).
  • Bacterial pneumonia.

People with HIV who smoke are more likely to have a poorer response to HIV treatment and a shorter lifespan than people with HIV who do not smoke. In fact, one studyExit Disclaimer found that people with HIV who are on antiretroviral therapy (ART) and have an undetectable viral load but who smoke are substantially more likely to die from lung cancer than from HIV itself.

Further, HIV itself is an independent risk factor for smoking-related cancers, and this is especially true for women with HIV. In other words, having HIV puts you at higher risk of getting smoking-related cancers beyond what would be expected from cigarette smoking alone.

And, even while smoking rates are declining overall in the United States, people with HIV are less likely to quit smoking than people in the general population.

Why Should You Quit Smoking?

Quitting smoking has major and immediate health benefits for all tobacco users, including those with HIV. In fact, quitting smoking may be one of the most important steps you can take to protect your health.

There are many health benefits of quitting smoking. Quitting will:

  • Lower your risk of at least 12 cancers, including lung cancer.
  • Lower your risk of cardiovascular disease, stroke, and COPD.
  • Lower your risk of poor reproductive outcomes, like having a low birthweight baby or preterm delivery.
  • Lower your chances for erectile dysfunction.
  • Reduce your belly fat and lower your risk of diabetes.
  • Provide benefits if you’ve already been diagnosed with coronary heart disease or COPD.
  • Improve your quality of life.
  • Increase your life expectancy.

Quitting smoking is beneficial to your health at any age, no matter how long or how much you have smoked.

How Can I Quit Smoking?

Talk with your health care provider about programs and products that can help you quit smoking. There isn’t one right way to quit, but certain things can be extra helpful. For example, quit smoking medications can double your chances of quitting for good. These quit smoking medications have few drug-drug interactions with HIV medicines, but always check with your HIV health care provider first.

Explore your options. In addition to quit smoking medications, there are other quit smoking methods like in-person counseling and support, telephone counseling and support, online programs, and others. Some quit smoking methods are free, while others have a small or even large cost. Some methods have side effects. Always read and follow the instructions on packages carefully. Explore your options and find a quit smoking method that’s right for you.

Get tips for quitting from Tips from Former Smokers, CDC’s national tobacco education campaign. The campaign features the real stories of people talking about how smoking has affected their lives and their other health conditions, including HIV.

Find more information on the health benefits of quitting smoking. Visit CDC’s There, you can find information, download quit smoking apps, and speak to an expert, by chat or by phone.

Remember, it’s never too late to quit.

Smoking and Acute Lung Infections like COVID-19, Influenza, and RSV

Being a current or former smoker can make you more likely to get severe illness from acute lung infections like COVID-19, influenza, and RSV compared to nonsmokers.

What Health Problems Are Caused by Secondhand Smoke?

Secondhand smoke exposure occurs when you breathe in smoke breathed out by people who smoke or from burning tobacco products. There is no risk-free level of secondhand smoke exposure; even brief exposure can be harmful to your health. It has immediate harmful effects on your heart and blood vessels, which can raise your risk for a heart attack, and causes heart disease, stroke, and lung cancer. Learn more about secondhand smoke.

What About E-Cigarettes?

E-cigarettes, also known as “e-cigs,” “vapes,” “e-hookahs,” and “vape pens” are products that heat a liquid usually containing nicotine into an aerosol that users breathe in and out. They come in many shapes and sizes. Bystanders can also breathe in this aerosol when the user exhales into the air. One studyExit Disclaimer showed that a higher proportion of people with diagnosed HIV use e-cigarettes than the overall U.S. adult population.

According to CDC, here’s the bottom line on e-cigarettes:

  • E-cigarettes have the potential to benefit adults who smoke and who are not pregnant if used as a complete substitute for regular cigarettes and other smoked tobacco products.
  • E-cigarettes are not safe for youth, young adults, pregnant adults, as well as adults who do not currently use tobacco products.
  • While e-cigarettes have the potential to benefit some people and harm others, scientists still have a lot to learn about whether e-cigarettes are effective in helping adults quit smoking.
  • If you’ve never smoked or used other tobacco products or e-cigarettes, don’t start.
  • Additional research can help understand long-term health effects.

Learn more: Get the facts about e-cigarettes, their health effects, and the risks of using them.