Research Spotlight: The Impact of Tobacco Smoking and Smoking Cessation on the Life Expectancy of People with HIV in South Africa

Krishna Reddy, MD, MS, a physician-investigator at the Medical Practice Evaluation Center and the Tobacco Research and Treatment Center at Massachusetts General Hospital and an Associate Professor of Medicine at Harvard Medical School, is the senior author of a recently published paper in Journal of the International AIDS Society: Tobacco Smoking, Smoking Cessation and Life Expectancy Among People with HIV on Antiretroviral Therapy in South Africa: A Simulation Modelling Study.

What Question Were You Investigating in this Study?

Now that more people with HIV in South Africa are on antiretroviral therapy (medicines to treat HIV), more are surviving long enough to face the health consequences of tobacco smoking.

Around one in four people in South Africa smoke tobacco, so this affects many people. Smoking appears to be even more common among people with HIV than among the general population.

Our team wanted to understand the impact of tobacco smoking and smoking cessation on the life expectancy of people with HIV in South Africa.

What Were the Results?

We found that smoking decreases the life expectancy of people with HIV on antiretroviral therapy in South Africa by three to six years, of which two to five years could be regained by smoking cessation.

Among people whose HIV is initially controlled with medicines, smoking decreases life expectancy more than HIV.

What are the Clinical Implications and Next Steps?

Integrating tobacco cessation interventions into HIV care, as suggested by the World Health Organization, could substantially improve life expectancy.

Smoking cessation interventions should become part of HIV care in South Africa and other low- and middle-income countries.

Paper Cited:

Thielking, A. M., Fitzmaurice, K. P., Sewpaul, R., Chrysanthopoulou, S. A., Dike, L., Levy, D. E., Rigotti, N. A., Siedner, M. J., Wood, R., Paltiel, A. D., Freedberg, K. A., Hyle, E. P., & Reddy, K. P. (2024). Tobacco smoking, smoking cessation and life expectancy among people with HIV on antiretroviral therapy in South Africa: a simulation modelling study. Journal of the International AIDS Society, 27(6), e26315. https://doi.org/10.1002/jia2.26315