AIDS and Behavior

, Volume 15, Issue 1, pp 243-251

First online:

Cigarette Smoking and Mortality Among HIV-Infected Individuals in Seattle, Washington (1996–2008)

  • Heather PinesAffiliated withDepartment of Epidemiology, University of Washington Email author 
  • , Laura KoutskyAffiliated withDepartment of Epidemiology, School of Public Health, University of Washington
  • , Susan BuskinAffiliated withDepartment of Epidemiology, School of Public Health, University of WashingtonHIV/AIDS Program, Public Health Seattle & King County

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HIV-infected individuals with access to highly active antiretroviral therapy (HAART) are living longer and the causes of excess morbidity and mortality among people living with HIV/AIDS (PLWHA) are becoming comparable to individuals without HIV infection. However, many PLWHA smoke cigarettes—a well known contributor to excess morbidity and mortality. To investigate the association between smoking and mortality among PLWHA during the HAART era (1996+), we conducted a retrospective cohort study of 2,108 PLWHA enrolled in Seattle and King County’s Adult and Adolescent Spectrum of HIV Disease Study. Adjusted hazard ratios (aHRs) for all-cause and cause-specific mortality were obtained using Cox proportional hazards regression. Compared to never smokers, current smokers (aHR = 1.8, 95% CI: 1.3, 2.3) and individuals with an increased dose and/or duration of smoking were at greater risk of all-cause mortality. Although additional research is needed to evaluate the full effect of smoking on cause-specific mortality, smoking cessation programs should target PLWHA to further increase their life expectancy.


HIV/AIDS Smoking Dose–response Pack-years All-cause mortality Cause-specific mortality