Abstract
The purpose of this study was to examine the effects of smoking (past and current) on multiple domains of cognitive functioning in a sample of people living with HIV/AIDS (PLWHA). We hypothesized that among PLWHA, current smokers would demonstrate poorer cognitive functioning when compared to non-smokers, specifically in the cognitive domains of auditory-verbal learning and memory, visuospatial memory, overall cognitive efficiency, executive skills, processing speed, and working memory. Results suggest that in patients being treated for HIV infection, current smoking is negatively associated with learning, memory, and global cognitive functioning. There was also some evidence that cognitive deficits in learning associated with smoking were more pronounced among men compared to women. However, the cause of these effects is not at all clear. In multivariate models, the differences associated with smoking were non-significant when adjusting for education and hepatitis C virus infection. Therefore, smoking may simply reflect a general tendency to more widespread deficits and comorbidities rather than directly impacting cognitive function. Future studies should attempt to examine a priori cognitive factors which contribute to smoking debut and other associated risk factors in order to understand why smoking may be a marker for other risk factors and may ultimately influence neurocognitive functioning critical to daily activities and adherence.
Acknowledgements
This work was supported by the National Institutes of Health (grants R01MH074368 and P01AA019072), and the Lifespan/Tufts/Brown Center for AIDS Research (grant P30AI042853). This research has been facilitated by the infrastructure and resources provided by the Brown University Center for Alcohol and Addiction Studies, the Lifespan/Tufts/Brown Center for AIDS Research and The Miriam Hospital Immunology Center. The authors have declared that no conflicts of interest exist.