Kinsey Confidential

Q: Recently I had an abnormal\nPap test result and my doctor diagnosed\nme with HPV. Since then,\nI've done my own research on HPV\nand consider myself to be pretty\nwell versed in the virus. I was quite\nshocked to learn that smoking can\nlead to HPV fl aring up in someone\nthat might have had the virus but\nhad not known it. Even before my\nresearch, I knew what HPV was and\nhow it was transmitted, but never\ndid I read anything about the smoking\nthing. Why is this fact not more\nwidely known? I ask this because\nI was a non-smoker until about a\nyear ago when I started smoking for\nseveral months and, I believe, this is\nwhy my test results came back HPV\npositive. If I had known about this\nlink I never would have smoked at\nall. Since my diagnosis, I have\nstopped smoking. However most of\nmy friends smoke and sometimes\nit is hard to endure without having\na drag off of one of their cigarettes.\nCould this small amount of smoking\nhave an effect on my HPV?

A: There are more than 100\nstrains of the human papillomavirus.\nSome of these strains can cause\ngenital warts and other strains can\ncause cervical changes that may result\nin an abnormal Pap test result.\nFor years, scientists have known\nthat cigarette smoking appears to\nincrease the risk of both cancerous\nand noncancerous conditions,\nincluding HPV-related cervical\nchanges and the appearance (and\nrecurrence of) genital warts. Although\nthis information is widely\navailable, you are correct that most\nyoung (and older) adults don't seem\nto have heard about the connection\nbetween smoking and HPV, which\nis a shame considering the large\nnumber of adolescents and adults\nwho smoke cigarettes.\nThat said, even when health educators\nand healthcare providers tell\nindividuals about the link between\nsmoking and HPV, the message\nmay not be memorable or meaningful\nto an individual unless it feels\npersonally relevant (as occurred\nwith you). Warnings about a range\nof health issues (e.g., drunk driving,\nheart disease, diabetes) tend to\nbecome meaningful when they become\npersonal (e.g., when it affects\nyou, a friend or a family member).\nHPV is a sexually transmitted\ninfection (STI). Even if a person\ndoes not smoke cigarettes, they may\nhave problems associated with HPV\n(such as cervical changes or genital\nwarts). Then again, many people do\nnot experience symptoms even if\nthey carry the virus. But people who\nhave HPV (and most sexually active\nadults have or have had HPV)\nare at particular risk for HPV-related\nproblems if they smoke cigarettes.\nIt is unclear how little or how\nmuch cigarette smoke it takes to\nsignifi cantly increase one's chance\nof having persistent HPV-related\nproblems -- and it depends on the\nindividual, one's genetic make-up\nand other risk factors. However, it is\nworth noting that not only have researchers\nfound a link between personal\nsmoking and HPV, but they\nhave also found an increased risk\nfor HPV-related problems and second\nhand smoking. Therefore, even\nbeing around your friends' smoke\nmay increase your risk.\nWhat can you do? One option is\nto be open with your friends about\nyour abnormal Pap test result and\nto ask for their help in keeping you\nhealthy, either by attending smoking\ncessation classes themselves\n(offered by many campus and community\nhealth centers), which may\nbenefi t them too, or by stepping\noutside or away from you when\nthey smoke. It may feel embarrassing\nto talk about your Pap test result\nbut considering that about 60 to 80\npercent of sexually active adults\nhave or have had HPV, it is possible\nthat some of your friends have HPV\ndiagnoses too.\nEven if you are not comfortable\nsharing your HPV diagnosis with\nyour friends, perhaps you can ask\nthem to support your non-smoking\nefforts by not smoking around you\nor by not letting you take a drag off\ntheir cigarettes. You may be able to\nidentify certain activities or certain\nfriends that put you in a situation in\nwhich you are more likely to smoke\n(e.g., when you have been drinking,\nat certain bars or house parties, or\naround certain people) and you may\nbe able to avoid these situations or\nask trusted friends to help keep you\naway from cigarette smoking.\nIn the end, though, this is your\nchoice: you said that you never\nwould have started smoking if you\nhad realized the link, and now you\nknow about the link. The choice\nis yours -- and the support to quit\nsmoking (through smoking cessations\nclasses and likely through\nfriends) is there for you to access.\nSmoking is very addictive and thus\nit can take attention or watchfulness\nto quit and maintain that behavior,\nbut it is certainly possible. Check\nout the CDC web site (www.cdc.\ngov) and the American Cancer Society\nweb site ( for\nadditional resources.

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