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People with HIV now lose more years of life to smoking than to HIV itself. About 1.2 million Americans are living with HIV, and while smoking among U.S. adults has fallen below 10% for the first time, people with HIV still smoke at up to four times that rate. Although many people with HIV want to quit smoking, their quit rates are much lower compared to the general population.

This picture is driven in part by a public health success story. Advances in antiretroviral therapies for HIV have transformed the diagnosis from a terminal illness into a manageable chronic disease. People with HIV can live long lives, which is cause for celebration. But it's also a catalyst to put more energy into ensuring people with HIV can avoid or reduce the long-term health harms of smoking.

This requires moving beyond a "more of the same" approach to smoking cessation, especially because people with HIV tend to have worse outcomes with traditional quit methods like counseling and medication. People with HIV face unique and complex barriers to quitting, so health care providers' toolkits should offer patients as many evidence-based pathways to cessation as possible.

This summer, we sat down virtually with two researchers who have spent decades working at the intersection of smoking and HIV. In a wide-ranging discussion, Lauren Pacek of Rutgers Health Institute for Nicotine and Tobacco Studies and Patricia Cioe of the University of Rhode Island College of Nursing shared their pragmatic, compassionate perspectives on this urgent public health issue.

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