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September 23, 1992

HIV Infection and Smoking Behavior-Reply

Author Affiliations

The Johns Hopkins University Baltimore, Md

JAMA. 1992;268(12):1540. doi:10.1001/jama.1992.03490120053021

In Reply.  —Drs Davis and Samet make an appropriate point regarding the need to determine if there is a reduced risk in former smokers as compared with current smokers. We chose to report smoking status as reported at the time of HIV serologic testing when we asked only if patients had ever smoked. A potential problem with the analyses proposed by Davis and Samet is the uncertain time of HIV infection. The HIV infection could have occurred before a smoker's quitting, thus diluting any association between smoking status and HIV infection. Prospective cohort studies of women at risk would be the best way to evaluate this association and any possible decrease in risk following cessation of smoking.As implied by Drs Phillips and Davey Smith, unprotected sexual intercourse with an HIV-infected man is undoubtedly the key factor in the acquisition of HIV infection in women. Our detailed histories of sexual