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Harm reduction for smokers living with HIV
The Lancet HIV ( IF 16.1 ) Pub Date : 2021-08-27 , DOI: 10.1016/s2352-3018(21)00156-9
Jonathan Shuter 1 , Krishna P Reddy 2 , Emily P Hyle 3 , Cassandra A Stanton 4 , Nancy A Rigotti 5
Affiliation  

Tobacco use is now a leading cause of death in people living with HIV in the USA. Increasing cessation rates in this group is a public health priority, yet the results of clinical trials aimed at optimising tobacco treatment strategies have been largely disappointing. Combinations of behavioural and pharmacological cessation therapies in people living with HIV have yielded increases in short-term quit rates, but few have shown long-term efficacy. Even with aggressive therapy combining intensive behavioural treatment with pharmacological agents, most smokers living with HIV continue to smoke. The generalised approach to tobacco treatment that prevails in guidelines and in clinical practices might do a disservice to these individuals, who represent a sizable segment of the population of people living with HIV. Harm reduction is a sensible and needed approach for smokers living with HIV who are unable or unwilling to quit. In this Viewpoint, we take an expansive view of harm reduction to include not only cutting down on cigarette intake for persistent smokers, but also reducing smoking's downstream health effects by increasing lung cancer screening and by controlling concurrent cardiovascular risk factors, especially hypertension and hyperlipidaemia.



中文翻译:

减少对感染艾滋病毒的吸烟者的伤害

烟草使用现在是美国艾滋病病毒感染者死亡的主要原因。提高这一群体的戒烟率是一项公共卫生优先事项,但旨在优化烟草治疗策略的临床试验结果在很大程度上令人失望。对 HIV 感染者进行行为和药物戒烟治疗的组合提高了短期戒烟率,但很少有人显示出长期疗效。即使采用将强化行为治疗与药物相结合的积极治疗,大多数感染 HIV 的吸烟者仍继续吸烟。指南和临床实践中普遍采用的烟草治疗方法可能会对这些人造成伤害,他们代表了艾滋病毒感染者中相当大的一部分。对于无法或不愿戒烟的艾滋病毒感染者来说,减少伤害是一种明智且必要的方法。在这个观点中,我们对减少危害采取了广泛的观点,不仅包括减少持续吸烟者的香烟摄入量,还包括通过增加肺癌筛查和控制并发心血管危险因素,特别是高血压和高脂血症来减少吸烟对下游健康的影响。

更新日期:2021-09-28
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