Objective:
To review literature on smoking among HIV positive people.

Methods:
Literature review.

Results:
Smoking-related morbidity and mortality is huge problem in HIV positive population. Cigarette smoking is one of the most important risk factors for a variety of serious clinical conditions, including CVD, pulmonary diseases and cancers. Some cancers have been included in the category of diseases that define AIDS. Introduction of antiretroviral treatment (ARV) changed the course of infection and decreased the incidence of diseases that define AIDS (including cancers). Unfortunately, the problem of cancer in the HIV + population has not disappeared. Before the introduction of ARV, non-AIDS-dependent cancers (NADCs) were responsible for less than 1% of deaths, currently it is 13% of deaths. NADCs occur in the younger age group and have more aggressive course. The low number of CD4 promote the development of some NADCs, including lung cancer. Lung cancer (mainly connected with smoking) is one of the most frequent NADCs (HIV infection 3.5-fold increases the risk). Also the risk of most tobacco-related diseases is significantly higher in people living with HIV, and the progression of already existing tobacco-related diseases is also faster among them. Epidemiological studies show that tobacco smoking is frequent among HIV-infected people (50-70%). The life expectancy of HIV-infected smokers is about 10 years shorter than that of HIV+ non-smokers. Tobacco-related diseases significantly reduce the effects of effective ARV and worsen quality of life. Lifestyle-related factors, may be greater threat to long-term survival of HIV-infected patients than those associated with HIV infection. Tobacco use is currently the highest health risk for people living with HIV.

Conclusions:
All doctors conducting ARV should offer to each smoker help to stop smoking. HIV-positive patients should be screened for smoking, and smokers should be enrolled in smoking cessation programs as a part of routine care. They need to be informed about the impact of smoking on HIV disease and its treatment.