Smoking and Lung Disease

Smoking doesn't make HIV infection worse. It doesn't cause CD4 cell counts to fall. It doesnÕt keep anti-HIV drugs from working.

People who have HIV and smoke are more likely to get certain infections and AIDS-defining illnesses. Some of the conditions that people with HIV who smoke are more likely to get include:

• Pneumocystis carnii pneumonia. Smokers are three times more likely than non-smokers to get this AIDS-defining disease.
• Bacterial pneumonia
• Thrush
• Emphysema. This disease causes the tiny air sacs in the lungs and the tiny blood vessels that feed them (capillaries) to collapse.
• Oral hairy leukoplakia
• Mycobacterium avium complex (MAC)
• Human papillomavirus in women. Women with HIV who smoke are more likely to get HPV. When they do get it, the infection is more likely to be more severe. HPV increases the risk that a woman will get cervical cancer.

All smokers have a greater risk of getting lung cancer, heart disease, high blood pressure and stroke. Some anti-HIV drugs can cause the fats in the blood to rise. This makes the risk of developing heart disease or stroke greater yet.

Risk Factors

Smoking causes harmful effects on the body in many ways. These effects make it harder for the body to fight off infections and destroy quality of life. All of them complicate living with and treating HIV infection. Some of the effects of smoking are:

• A faster heart rate and higher blood vessel. The nicotine in tobacco speeds up most of the processes in the body. The smoke itself contains carbon monoxide. The blood is more likely to absorb carbon monoxide than carbon dioxide. As a result, the body gets less oxygen.

• Tar coats the lungs, even if a person is smoking low-tar cigarette. This makes it impossible for the tiny hairs that line the airways of the nose and lungs to work to get rid of dust, bacteria and other things that are breathed into the body.
• Poor circulation. Nicotine causes the blood vessels to close up. This cuts off oxygen to the hands and feet. It can also increase the risk of heart attacks and strokes.
• Appetite loss. This can make it harder for a person with HIV to get the nutrition they need and to follow instructions for taking anti-HIV drugs with food.
• Damage from the more than 4,000 chemicals found in tobacco smoke. More than 60 of these chemicals are known to cause cancer. Some of these include formaldehyde, which is used to preserve dead bodies; ammonia; acetone, which is used in nail polish remover; nicotine, which is used in insecticides; and arsenic.

It should be noted that these effects are caused by tobacco. Chewing tobacco can be as harmful as tobacco that is smoked in the form of cigarettes, cigars or pipes. Smoking marijuana has many of the same effects on the lungs as smoking tobacco.

Other effects of smoking of concern to a person with HIV are:

• Increasing the risk of osteoporosis
• Making it harder for the liver to process drugs. It can make liver-related conditions like hepatitis worse.
• Making side effects such as nausea and vomiting from anti-HIV drugs worse
• Weakening of the immune system. It increases the risk of chronic lung disease. It can make it harder to fight off HIV-related infections

Treatment

"Giving up smoking is the easiest thing in world", writer Mark Twain once said. I know because I've done it thousands of times.

Nicotine is one of the most addictive substances known. Some people have compared quitting smoking to giving up heroin. The act of smoking is a habit that gets built into daily act of living. Even so, thousands of people have quit smoking.

No matter how long a person has been smoking, stopping brings better health almost immediately. The longer a person goes without smoking, the more health improvements there are.

When a person quits smoking, he or she will have signs of nicotine withdrawal. These may include anxiety, anger, irritability, impatience and restlessness. Other symptoms are having a hard time concentrating; trouble sleeping; cravings; stomach pain, nausea or constipation; depression; and hunger. These go away in time as the body adjusts to life without nicotine.

There are many ways to quit smoking. If one way isnÕt successful, another might be. Sometimes using several at once helps. Some of the common ways of quitting are:

• Cold turkey. This means never having another cigarette or form of tobacco again.
• Nicotine replacement aides. These come in the form of gums, lozenges, patches or inhalers. They are designed to give a small amount of nicotine to control the worst of the cravings. These aides are then tapered off.
• Drugs to help with the withdrawal symptoms. One is the antidepressant bupropion (Zyban¨). Protease inhibitors and non-nucleoside reverse transcriptase inhibitors (NNRTI) used to fight HIV will increase the amount of Zyban in the blood.
• Joining a support group. Being with others going through the same experience can keep the motivation to quit higher.
• Acupuncture or hypnosis

Other things that can make it a little easier to quit are:

• Getting exercise. This helps with the anxiety and irritability and makes it easier to sleep.
• Drinking lot of water. This will help flush the nicotine from the body.
• Getting plenty of sleep.
• Changing routines and habits to avoid triggering cravings

Talking to a doctor or a person trained to help people quit smoking can help find the best way to give up tobacco.