Excellent article from Krishna Reddy at MGH. Dr. Reddy is an expert on modeling and simulation, and here he used validated inputs to model the impact of smoking exposure and intensity on lung cancer mortality in persons living with HIV (PLWH). What he found is that ongoing smokers (even light smokers) face a high risk of lung cancer death (on the order of 20+ % chance of lung cancer death over lifetime) but that this could be greatly attenuated by quitting smoking. Moreover, the risk of dying from lung cancer in PLWH who smoker is MUCH higher than dying from AIDS-related causes in the current era.

PLWH are much more likely to smoke than other patients and this is likely related to a host of factors: disparities in care, socioeconomic status, stigma related to being HIV+ and being LGBT, social norms within the LGBT community, etc. What is really lacking is more evidence and best practices for targeted smoking cessation interventions in PLWH. If things don't change, Reductions in smoking among PLWH will likely more towards eliminating any differences in life expectancy compared to uninfected patients.