An additional 1.3 million people acquired HIV in 2024, according to the WHO, but medical advances, and the increasingly widespread availability of antiretroviral therapies (ART), mean that many people living with HIV who have access to good healthcare now
What is the impact of smoking on people living with HIV and how could tobacco harm reduction help?
The World Health Organization (WHO) estimates there were 40.8 million people living with HIV at the end of 2024, of which 1.4 million were aged 14 and under.[1] The vast majority live in Africa (26.3 million), but HIV continues to be a global issue, with 4.2 million people living with HIV in the Americas, 3.5 million in South-East Asia, 3.2 million in Europe, 3 million in the Western Pacific, and 610,000 in the Eastern Mediterranean.
An additional 1.3 million people acquired HIV in 2024, according to the WHO, but medical advances, and the increasingly widespread availability of antiretroviral therapies (ART), mean that many people living with HIV who have access to good healthcare now have the possibility of similar life expectancies to those of the general population.[2]
Efforts to tackle HIV and reduce related death and morbidity have been one of the great public health successes of the last thirty years, particularly in those countries with well-resourced health services. However, many of these gains are undermined by a failure to make use of all the available tools to tackle high rates of smoking among people living with HIV. In many populations of people living with HIV who are being treated with ART, those who smoke are more likely to die from smoking-related diseases than from HIV.
HIV services need to engage clients in quitting smoking. However, a lack of training, an absence of guidelines, a lack of resources for, and the limitations of, conventional smoking cessation treatment, as well as a focus on other healthcare priorities, have resulted in lost opportunities for helping people quit smoking. For HIV services, offering tobacco harm reduction using safer nicotine products (SNP) can be readily implemented, and is a low-cost, high-impact intervention. (GSTHR - Global State of Tobacco Harm Reduction, März 2026)