Dr. Jonathan Shuter, an infectious disease physician at Montefiore Einstein and professor of medicine at Albert Einstein College of Medicine in New York, said in an interview with TheBodyPro that smoking-related illnesses now kill more people living with HIV in the United States than the virus itself. He said smoking rates among people with HIV remain around 40% — far higher than in the general population — and that cessation programs have produced disappointing results, with only about one in five smokers successfully quitting.
Shuter argued that clinicians should adopt a broader harm reduction approach that supports patients who reduce smoking even if they do not quit completely, while emphasizing lung cancer screening, cardiovascular risk management, and tailored interventions that address the different reasons people with HIV smoke. Shuter also said complete switching from cigarettes to vaping could reduce harm compared with smoking, but cautioned that dual use of cigarettes and e-cigarettes offers little health benefit and remains the more common pattern among people living with HIV.