November 1, 2006

Q&A: The Connection Between Smoking And HPV

A reader is shocked to learn that smoking can lead to HPV flare ups and asks why this fact is not more widely known

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Question: Recently I had an abnormal Pap test result and my doctor diagnosed me with HPV. Since then, I’ve done my own research on HPV and consider myself to be pretty well versed in the virus. I was quite shocked to learn that smoking can lead to HPV flaring up in someone that might have had the virus but had not known it. Why is this fact not more widely known?

There are more than 100 strains of the human papillomavirus. Some of these strains can cause genital warts and other strains can cause cervical changes that may result in an abnormal Pap test result.

For years, scientists have known that cigarette smoking appears to increase the risk of both cancerous and noncancerous conditions, including HPV-related cervical changes and the appearance (and recurrence of) genital warts. Although this information is widely available, you are correct that most young (and older) adults don’t seem to have heard about the connection between smoking and HPV, which is a shame considering the large number of adolescents and adults who smoke cigarettes.

That said, even when health educators and healthcare providers tell individuals about the link between smoking and HPV, the message may not be memorable or meaningful to an individual unless it feels personally relevant (as occurred with you). Warnings about a range of health issues (e.g., drunk driving, heart disease, diabetes) tend to become meaningful when they become personal (e.g., when it affects you, a friend or a family member).

Increased HPV Risk For Smokers

HPV is a sexually transmitted infection (STI). Even if a person does not smoke cigarettes, they may have problems associated with HPV (such as cervical changes or genital warts). Then again, many people do not experience symptoms even if they carry the virus. But people who have HPV (and most sexually active adults have or have had HPV) are at particular risk for HPV-related problems if they smoke cigarettes.

It is unclear how little or how much cigarette smoke it takes to significantly increase one’s chance of having persistent HPV-related problems — and it depends on the individual, one’s genetic make-up and other risk factors. However, it is worth noting that not only have researchers found a link between personal smoking and HPV, but they have also found an increased risk for HPV-related problems with second hand smoking. Therefore, even being around your friends’ smoke may increase your risk.

What Can You Do?

One option is to be open with your friends about your abnormal Pap test result and to ask for their help in keeping you healthy, either by attending smoking cessation classes themselves (offered by many campus and community health centers), which may benefit them too, or by stepping outside or away from you when they smoke.

It may feel embarrassing to talk about your Pap test result but considering that about 60 to 80 percent of sexually active
adults have or have had HPV, it is possible that some of your friends have HPV diagnoses too. Even if you are not comfortable sharing your HPV diagnosis with your friends, perhaps you can ask them to support your non-smoking efforts by not smoking around you or by not letting you take a drag off their cigarettes.

You may be able to identify certain activities or certain friends that put you in a situation in which you are more likely to smoke (e.g., when you have been drinking, at certain bars or house parties, or around certain people) and you may be able to avoid these situations or ask trusted friends to help keep you away from cigarette smoking.

The Choice Is Yours

In the end, though, this is your choice: you said that you never would have started smoking if you had realized the link, and now you know about the link. The choice is yours — and the support to quit smoking (through smoking cessations classes and likely through friends) is there for you to access. Smoking is very addictive and thus it can take attention or watchfulness to quit and maintain that behavior, but it is certainly possible.

Learn More

Check out the CDC web site and the American Cancer Society web site for additional resources.

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