HIV and Tobacco Use

Our work in tobacco use and HIV evaluates the mechanisms and outcomes of tobacco use among people with HIV (PWH), a population with disproportionately high smoking rates. Coupled with the widespread use of antiretroviral therapy – which has substantially reduced mortality rates – PWH actually lose more life years to tobacco use than to HIV.

Dr. Ashare is currently conducting three research projects that address this problem from three perspectives to better understand: (1) the mechanisms that underlie high smoking rates; (2) why existing treatments are less effective and relapse rates are higher among PWH; and (3) how HIV and smoking may act synergistically and ultimately lead to worse clinical outcomes including cancer and impaired immune function. These translational studies incorporate biological (e.g., nicotine metabolism, inflammation), behavioral, and cognitive assessments address these questions. 

Selected Publications

Bidirectional Associations among Nicotine and Tobacco Smoke, NeuroHIV, and Antiretroviral Therapy.

HIV Infection Does Not Explain Higher Nicotine Metabolism

Patterns of Lapses and Recoveries During a Quit Attempt using Varenicline and Behavioral Counseling among Smokers with and without HIV. 

The effect of varenicline on mood and cognition in smokers with HIV. 

A Placebo-Controlled Randomized Clinical Trial Testing the Efficacy and Safety of Varenicline for Smokers with HIV. 

Differences in the rate of nicotine metabolism among smokers with and without HIV. 

The nature and consequences of cognitive deficits among tobacco smokers with HIV: a comparison to tobacco smokers without HIV.

This work is supported by:

Funding from the National Institutes of Health

  • R01-DA042682 (Ashare, PI)
  • R01-DA044906 (Ashare/Collman, MPI)
  • R01 HL151292 (Gross/Ashare, MPI)

Core support from

  • Penn Center for AIDS Research (CFAR)
  • Penn Mental Health AIDS Research Center (PMHARC)