Among patients with human immunodeficiency virus (HIV) infection, smoking is associated with a higher risk of mortality and HIV-related complications. In South Korea, public health authorities have expressed particular concern for smoking in HIV patients due to the habit’s relatively high societal acceptance compared to peer countries. In a recent publication in Epidemiology and Health, Boyoung Park and colleagues analysed national health data to detect an alarmingly high rate of smoking among South Koreans with HIV. GlobalData epidemiologists forecast a slight decline in the diagnosed prevalent cases of HIV in South Korea from over 16,500 cases in 2025 to approximately 16,300 cases in 2029. To avert a greater risk of death and severe comorbidities in this vulnerable population, it is incumbent upon South Korean health authorities and healthcare professionals to curb smoking rates using targeted interventions.
Park and colleagues conducted their analysis using three nationally representative databases linked to South Korea’s national health insurance system and national health survey data, yielding samples of 10,980 and 76,783 participants, respectively, over the age of 20 years. In addition, the authors utilised a database specifically measuring health characteristics among 1,230 HIV patients within the same age group. Within each cohort, current smoking status data was available. Analysis showed that the prevalence of current smoking among participants with HIV was 45.95%, compared to 22.5% in the general adult population. Furthermore, analysis of historical smoking data suggests that the prevalence of active smoking has increased among HIV patients in recent years, in a reversal of the steady decline seen between 2009 and 2020. By contrast, the general population has continued to see a decrease in the prevalence of smoking. The authors posit that this unique shift may be attributed to differences in socioeconomic status, ethnicity, and other risk factors among many HIV patients when compared with the general population. Furthermore, they posit that smoking cessation campaigns launched by the South Korean Government and civil society may have less effectively reached people with HIV. A final consideration is nicotine metabolism, which literature has suggested to be more rapid in those with HIV, leading to higher rates of nicotine dependence.
The work of Park and colleagues signals a troubling trend in health behaviour among HIV patients, which in turn presents opportunities for change. While smoking cessation campaigns have either been launched in the general population or other demographic groups, few have specifically targeted HIV patients. To address this oversight, the authors propose that health authorities and healthcare providers integrate smoking cessation efforts into standard HIV care procedures. These suggestions, especially if accompanied by targeted public campaigns targeted at groups with HIV or vulnerable to HIV infection, could lead to significant impacts on the health status of South Korean HIV patients.
