Journal of General Internal Medicine

, Volume 20, Issue 12, pp 1142–1145

The impact of cigarette smoking on mortality, quality of life, and comorbid illness among HIV-positive veterans

  • Kristina Crothers
  • Tephany A. Griffith
  • Kathleen A. McGinnis
  • Maria C. Rodriguez-Barradas
  • David A. Leaf
  • Sharon Weissman
  • Cynthia L. Gibert
  • Adeel A. Butt
  • Amy C. Justice
Populations At Risk

DOI: 10.1111/j.1525-1497.2005.0255.x

Cite this article as:
Crothers, K., Griffith, T.A., McGinnis, K.A. et al. J GEN INTERN MED (2005) 20: 1142. doi:10.1111/j.1525-1497.2005.0255.x


BACKGROUND: The impact of smoking on outcomes among those with HIV infection has not been determined in the era of highly active antiretroviral therapy (HAART).

STUDY OBJECTIVE: Determine the impact of smoking on morbidity and mortality in HIV-positive patients post-HAART.

DESIGN: Prospective observational study.

PARTICIPANTS: Eight hundred and sixty-seven HIV-positive veterans enrolled in the Veterans Aging Cohort 3 Site Study.

MEASUREMENTS: Clinical data were collected through patient questionnaire, International Classification of Diseases—9th edition codes, and standardized chart extraction, and laboratory and mortality data through the national VA database. Quality of life was assessed with the physical component summary (PCS) of the Short-Form 12.

RESULTS: Current smokers had increased respiratory symptoms, chronic obstructive pulmonary disease (COPD), and bacterial pneumonia. In analyses adjusted for age, race/ethnicity, CD4 cell count, HIV RNA level, hemoglobin, illegal drug and alcohol use, quality of life was substantially decreased (β=−3.3, 95% confidence interval [CI] −5.3 to −1.4) and mortality was significantly increased (hazard ratio 1.99, 95% CI 1.03 to 3.86) in current smokers compared with never smokers.

CONCLUSIONS: HIV-positive patients who currently smoke have increased mortality and decreased quality of life, as well as increased respiratory symptoms, COPD, and bacterial pneumonia. These findings suggest that smoking cessation should be emphasized for HIV-infected patients.

Key Words

HIVAIDSsmokingmortalityhealth-related quality of life

Copyright information

© Society of General Internal Medicine 2005

Authors and Affiliations

  • Kristina Crothers
    • 1
  • Tephany A. Griffith
    • 2
  • Kathleen A. McGinnis
    • 3
  • Maria C. Rodriguez-Barradas
    • 4
  • David A. Leaf
    • 5
    • 6
  • Sharon Weissman
    • 7
  • Cynthia L. Gibert
    • 8
    • 9
  • Adeel A. Butt
    • 10
  • Amy C. Justice
    • 11
  1. 1.Pulmonary and Critical Care Medicine, Department of Internal MedicineYale University School of MedicineNew HavenUSA
  2. 2.General Internal Medicine, Department of Internal MedicineYale University School of MedicineNew HavenUSA
  3. 3.University Center for Social and Urban Research, University of Pittsburgh, and Center for Health Equity Research and PromotionVA Pittsburgh Healthcare SystemPittsburghUSA
  4. 4.Medical Service, Infectious Diseases, Michael E. DeBakey VA Medical Center, and Department of MedicineBaylor College of MedicineHoustonUSA
  5. 5.General Internal Medicine, Department of Internal MedicineUniversity of CaliforniaLos Angeles
  6. 6.Greater Los Angeles VA Medical CenterLos AngelesUSA
  7. 7.Department of Internal MedicineHospital of Saint RaphaelNew HavenUSA
  8. 8.Department of MedicineGeorge Washington UniversityUSA
  9. 9.Section of Infectious DiseasesVA Medical CenterUSA
  10. 10.Infectious Diseases, Department of Internal MedicineUniversity of Pittsburgh School of MedicinePittsburghUSA
  11. 11.General Internal Medicine, Department of Internal MedicineVA Connecticut Healthcare System, and Yale University School of MedicineNew HavenUSA