More than 40% of people with human immunodeficiency virus (PWH) in the United States smoke tobacco cigarettes. Among those on antiretroviral therapy, smoking decreases life expectancy more than human immunodeficiency virus (HIV) itself. Most PWH who smoke want to quit, but tobacco dependence treatment has not been widely integrated into HIV care. This article summarizes the epidemiology of tobacco use among PWH, health consequences of tobacco use and benefits of cessation in PWH, and studies of treatment for tobacco dependence among the general population and among PWH. We provide practical guidance for providers to treat tobacco dependence among PWH. A 3-step Ask-Advise-Connect framework includes asking about tobacco use routinely during clinical encounters, advising about tobacco cessation with emphasis on the benefits of cessation, and actively connecting patients to cessation treatments, including prescription of pharmacotherapy (preferably varenicline) and direct connection to behavioral interventions via telephone quitline or other means to increase the likelihood of a successful quit attempt.

中文翻译：

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人类免疫缺陷病毒感染者的烟草使用和烟草依赖治疗：临床医生实用指南

在美国，超过 40% 的人类免疫缺陷病毒 (PWH) 感染者吸烟。在那些接受抗逆转录病毒治疗的人中，吸烟比人类免疫缺陷病毒 (HIV) 本身更能缩短预期寿命。大多数吸烟的 PWH 都想戒烟，但烟草依赖治疗尚未广泛纳入 HIV 护理。本文总结了 PWH 中烟草使用的流行病学、PWH 中烟草使用的健康后果和戒烟的好处，以及一般人群和 PWH 中烟草依赖治疗的研究。我们为提供者提供实用指南，以治疗 PWH 中的烟草依赖。Ask-Advise-Connect 三步框架包括在临床就诊期间常规询问烟草使用情况，建议戒烟并强调戒烟的好处，