Hepatitis C

Smoking Is an Epidemic Among HCV Patients

The rate of cigarette smoking among patients with hepatitis C virus (HCV) has reached epidemic levels, the results of a new study show.

For their study, the researchers assessed available data on 39,472 of 43,793 adult participants in the 1999-2014 National Health and Nutrition Examination Survey (NHANES). Patients with HCV were compared with those without HCV, both in the entire sample and within a subset of current cigarette smokers.

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Cigarettes per day, nicotine dependence, substance use, medical and psychiatric comorbidities, and various other factors were measured.

Findings from the study indicated that men and women with HCV smoked almost 3 times as much as those without HCV (62.4% vs 22.9%), and that smokers with HCV had higher odds of daily smoking vs smokers without HCV (87.5 vs 80.0%) but had similar levels of nicotine dependence.

The researchers also found that many smokers with HCV in this sample were older (mean age 47.1 years vs 41.5 years), were men (69.4% vs 54.4%), were cocaine (11.1% vs 3.2%) and heroin (4.0% vs 0.6%) users, and had depression (33.2% vs 13.5%) compared with smokers without HCV.

Furthermore, results of multivariate analyses demonstrated that cigarette smoking in HCV patients was significantly associated with current depression and hypertension.

“There is a cigarette smoking epidemic embedded within the hepatitis C epidemic in the US,” the researchers concluded. “The sociodemographic profile of [hepatitis C-positive] smokers suggests that the implementation of effective tobacco treatment will be challenging. Thoughtful treatment strategies that are mindful of the unique characteristics of this group are needed.”

—Christina Vogt


Kim RS, Weinberger AH, Chander G, Sulkowski MS, Norton B, Shuter J. Cigarette smoking in persons living with hepatitis C: the National Health and Nutrition Examination Survey (NHANES), 1999-2014 [published online February 3, 2018]. Am J Med.