What Are the Health Effects of Electronic Cigarette Use Among People Living With HIV?

People living with HIV smoke cigarettes at higher rates and face significantly more smoking-related morbidity and mortality compared to the general population of smokers. Prior research has shown that smoking cessation is substantially lower among people living with HIV and highlighted the ambivalence individuals may have about quitting.

A recent study, presented in an oral abstract session at the Association of Nurses in AIDS Care Conference (ANAC 2019), examined the acceptability, behaviors, and health-related effects of electronic cigarette use in smokers living with HIV who were not seeking smoking cessation treatment. Investigators from Brown University found that transitioning smokers living with HIV from combustible cigarettes to electronic cigarettes appears to be feasible, may lead to reduced toxicant exposure, reduced combustible cigarette use and dependence, and increased motivation to quit.

Contagion® spoke with the abstract presenter, Patricia Cioe, PhD, CNP, assistant professor, Department of Behavioral and Social Sciences, Brown University, at the conference to learn more about the research.

A total of 20 smokers who were living with HIV were enrolled in the study. Participants were recruited from 2 HIV clinics in the Northeastern United States. Baseline assessments of cigarette dependence and quit motivation were conducted and electronic cigarettes were provided. 8 Eight weekly visits followed, during which investigators collected self-reported and biological data. The participants were provided with weekly electronic liquid and encouraged to use the electronic cigarette at points when they would normally smoke combustible cigarettes. Follow-up assessments and brief qualitative interviews were conducted at week 12.

All 20 study participants were on antiretroviral therapy. Of the 20 individuals, 17 participants had an undetectable HIV viral load. The mean age was 52.7 years, with a mean duration of years living with HIV of 21.1 years. Mean combustible cigarette consumption per day was reduced from 15.1 (standard deviation [SD] 9.6) to 1.79 (SD 2.2), an over 80% reduction by week 8. By the end of the study, 6 participants had transitioned completely from combustible to electronic cigarettes, reporting no combustible cigarette consumption in the past week.

Carbon monoxide levels decreased from 15.7 parts per million (ppm) (M; SD 7.6) to 6.7ppm (M; SD 5.6). Combustible cigarette dependence scores dropped significantly, while contemplation ladder scores indicating quit motivation increased over time.

The authors concluded that switching from combustible cigarettes to electronic cigarettes may be a promising tool for harm reduction in smokers living with HIV who are unwilling or unable to quit smoking combustible cigarettes.

Cioe also spoke to Contaion® about the recent rise in cases of acute lung injury and how this affects electronic cigarette use.

The abstract, An Open Pilot to Examine the Acceptability and Health Effects of Electronic Cigarettes in HIV-Positive Smokers, was presented in an oral abstract session at ANAC 2019 in Portland, Oregon.