I’m neither HIV+, nor do I particularly like cancer sticks. For one thing, I’ve had a history of respiratory illness myself, and couldn’t go to gay pubs because of the large number of lesbians and gay men doing chimney impersonations. Happily, along came the Clark administration and its anti-smoking legislation, which was intended to protect union members from exposure to second-hand smoke, but which also provided a more clement environment for those of us who wanted a night out without ending it wheezing, coughing and feeling nauseous.

I’m anti-smoking because both of my maternal grandparents died from emphysema and lung cancer respectively, due to the large amount of nicotine they smoked each day. I’m not judgemental as much as I was. Until recently, I worked with a mental health consumers aid group, and learnt that some people who live with schizophrenia tended to use nicotine to blot out people’s adverse responses to older atypical antipsychotics, including word salad/alogia, nausea and vomiting. Fortunately, their new meds don’t have those side-effects.

Granted, lesbian and gay smokers use ciggies for homophobic stress relief, mostly. And I also realise that my own addiction to small brown sweet-tasting lumps of theobromine (chocolate) isn’t doing my waistline any favours, even if it’s good for one’s serotonin levels.

When I read Paul Thorn’s article in a recent Gay Times, I decided to have a look at the UK Gay Men Fighting AIDS’ anti-smoking website, and found out the following:

Smoking doesn’t result in any faster progression toward end-stage AIDS. However, because HIV/AIDS depresses one’s immune system, HIV+ smokers may be more at risk of smoking related health problems than their HIV- counterparts.

These include:

1. Cardiovascular events such as high blood pressure, heart disease and heart attacks
2. Cerebrovascular events such as strokes
3. Malignancies such as lung cancer, anal cancer, mouth cancer, throat cancer, stomach cancer, head and neck cancer
4. Decreased lung function, chest infections, chronic inflammation of the lungs and airways
5. Emphysema and chronic bronchitis
6. Mouth problems such as gingivitis, periodontitis, thrush and OHL
7. Brain degenerative disorders such as impaired cognitive function and dementia

However, they’re not neccessarily more common amongst older HIV+ people, as they can also occur with people with relatively high levels of immune system integrity, and have become increasingly common in HIV+ people under forty. For those with low CD4 counts, though, there is an increased risk of opportunistic smoking-related infections in the

mouth, lungs and airways. HIV positive smokers with low CD4 counts are therefore at a higher risk of infections such as oral hairy leukoplakia, bacterial pneumonia and thrush. More worryingly, smoking also increases the risk of developing PCP if you have a low CD4 count, and this infection can prove fatal.

I hope I’m not laying a heavy moralistic trip on PLWAs and HIV+ folks in discussing this. If it sounds like I am, it’s only because I value and cherish them and their contributions to our communities, and I want to see them alive and well for as long as possible.

Recommended:
http://www.gmfa.org.uk/positive/looking-after-yourself/smoking

Gay Men Fighting AIDS (UK): Smoking and HIV/AIDS