SRNT Update 4: Tobacco and People Living With Cancer and HIV/AIDS

So this is day 3 for me in Baltimore and so far, aside of a little detour into food-poisoning-land, it’s been great.  Last night I got to see the touring Broadway show In The Heights and got to see it snow for the first time in my life. Both were great, in case you were wondering, although I felt like my ears were going to fall off (I mean in reference to the cold of the snow, not because of the show).  But you don’t want to hear about me, you want to hear bout the SRNT conference. 

On this update I wanted to focus on an excellent presentation give by Dr. Ellen Gritz on cancer and HIV/AIDS patients and tobacco use.  Turns out that over 20% of people living with cancer continue to smoke.  Yikes!  So obvious not only could tobacco use have contributed to the onset of cancer but there are other downsides once a person living with cancer continues to smoke.  For starters, it can worsen the side effects of treatment, however it also has adverse effects on the efficacy of treatment too.  If undergoing surgery, it can increase the complications of general anesthesia and detrimental to wound healing.  If a cancer patient is undergoing radiation, smoking can increase the toxicity of the treatment.  Nicotine itself induces resistance to chemotherapy.

After talking about the detrimental effects of tobacco on cancer, Dr. Gritz switched over to talking about the effects on people living with HIV/AIDS, and I got smarter and instead of typing on my computer I began to take pictures of slides…alright, so I copied it from someone in front of me, at least I know when to follow a good idea.

Anyway, as you can read in the picture below, smoking is a major cause of cardiovascular disease (CVD), and CVD has been rearing its ugly head more in this population as people living with HIV/AIDS have longer life expectancies.  Cancer also tends to be one of the top reasons of death for this population.  So there’s this terrible cycle that is perpetuated by continuing to smoke while living with HIV/AIDS. 

Me being smart and taking pics of the screen instead of notes

BUT, and that’s a big J.Lo BUT, the good news is that people with cancer and HIV/AIDS have shown that they want to quit just like everyone else.  Dr. Gritz ended by showing a pilot a project, conducted by Dr. Gary Humfleet from the University of California, San Francisco, which has shown that people with HIV/AIDS can quit tobacco right along with the rest of us.  Basically, follow the recommendations that are set forth in the mighty Quit Tobacco Bible (The Treating Tobacco Use and Dependence Clinical Practice Guidelines), but address barriers that are specific to people living with HIV/AIDS.  One the points that Dr. Humfleet clarified for me was that people with HIV/AIDS could be prescribed NRT.  I got to meet Dr. Humfleet during one of the posters sessions after a tip from Gustavo that he was in attendance.

Implications from all this is that we, as tobacco control advocates, should concentrate on building cessation programs that target people with caner and HIV/AIDS.  Furthermore, the old stereotype that people facing these challenges will not want to quit, because that’s a bunch of bologna.   Not only do these people want to quit just like most smokers do, they can, and they have a heightened risk of smoking interfering with their very important treatment.  Encourage clinicians to approach the subject of tobacco with their clients, and if they say “they won’t want to quit” tell them Pedro said “Si Se Puede!”

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