Smoking and HIV: confronting the epidemic

Abstract

Although the global prevalence of cigarette smoking has declined, the proportion of people living with HIV who are smokers remains high and is about double that in the general population. 1 Mdodo R Frazier EL Dube SR et al. Cigarette smoking prevalence among adults with HIV compared with the general adult population in the United States: cross-sectional surveys. Ann Intern Med. 2015; 162: 335-344 Crossref PubMed Scopus (302) Google Scholar Despite the high prevalence, the research examining smoking cessation in people living with HIV is surprisingly sparse. 2 Pool ER Dogar O Lindsay RP Weatherburn P Siddiqi K Interventions for tobacco use cessation in people living with HIV and AIDS. Cochrane Database Syst Rev. 2016; 6 (CD011120) Google Scholar Thus, the study by Mercié and colleagues, 3 Mercié P Arsandaux J Katlama C et al. Efficacy and safety of varenicline for smoking cessation among people living with HIV in France (ANRS 144 Inter-ACTIV): a randomised controlled phase 3 clinical trial. Lancet HIV. 2018; (published online Jan 9. http://dx.doi.org/10.1016/S2352-3018(18)30002-X) Summary Full Text Full Text PDF PubMed Scopus (36) Google Scholar reported in The Lancet HIV, is a notable contribution. This double-blind, placebo-controlled phase 3 clinical trial showed that a 3 month course of varenicline combined with smoking cessation counselling was associated with a significantly higher proportion of participants who were biochemically confirmed as abstinent at 48 weeks compared with placebo and counselling (18 [15%, 95% CI 8–21] of 123 patients in the varenicline group vs eight [6%, 95% CI 2–11] of 124 patients in the placebo group; p=0·036). The study is the first high-quality investigation showing a long-term benefit of a smoking cessation intervention in HIV. 2 Pool ER Dogar O Lindsay RP Weatherburn P Siddiqi K Interventions for tobacco use cessation in people living with HIV and AIDS. Cochrane Database Syst Rev. 2016; 6 (CD011120) Google Scholar Efficacy and safety of varenicline for smoking cessation in people living with HIV in France (ANRS 144 Inter-ACTIV): a randomised controlled phase 3 clinical trialVarenicline is safe and efficacious for smoking cessation in people living with HIV and should be recommended as the standard of care. Full-Text PDF