Smoking impacts HPV recovery – but too few people know the risks

It’s no secret that smoking is harmful for our health.

In fact, pictures illustrating the potential consequences are plastered on every packet of cigarettes, along with messages warning us of risk.

We’ve come a long way since the indoor smoking ban of 2007, and the government has pledged for England to be smokefree (meaning fewer than 5% of the population smoke) by 2030.

Yet, despite a wealth of information about tobacco’s effects on the body, the scale of this damage is still not widely known among the public – including how it messes with our reproductive systems.

Professor of Respiratory Medicine at the National Heart and Lung Institute, Nick Hopkinson, who is also Chair of Action on Smoking and Health, tells Metro.co.uk: ‘The toxic chemicals from cigarette smoke that people breathe in are harmful to the lungs, but also pass through into the bloodstream so they get transported to all the organs in the body to cause damage.

‘Chemicals from smoking damage DNA and disrupt repair mechanisms in cells both of which increase the risk of cancer. More specifically, smoking increases the risk of human papillomavirus (HPV) infection which is the major risk factor for cervical cancer.’

Research by Yale University’s Department of Obstetrics and Gynecology found that 96% to 99% of women were aware that smoking causes respiratory disease, lung cancer, and heart disease, but just 22% knew it could cause infertility.

Less than a quarter of respondents were aware of a link between tobacco use and cervical cancer, which is worrying given significant evidence suggesting otherwise.

According to an investigation in the European Journal of Gynaecological Oncology, tobacco is ‘the most important cofactor of progression’ when it comes to HPV, an infection that can lead to cancer.

The study states that tobacco use ‘increases the risk from two to four times compared to non-smoking women,’ with even passive smoking having an impact on patient outcomes.

During research for this piece, women also reported being unable to clear HPV while smoking – and then the virus suddenly lifting once quitting.

It’s said that there are a number of factors involved in this, from smoking increasing oxidative stress on the body to chemicals in tobacco reducing immunosuppression and Lanerghans Cells which protect it.

Nicotine and tobacco carcinogens have even been found in the cervical mucus of smokers, which academics claim ‘supports the hypothesis that there is a synergic action between tobacco and HPV in the development of high-grade cervical intraepithelial lesions and cervical carcinoma.’

If that sounds like a whole lot of medical jargon to you, you’re not alone. Policymakers have been trying for decades to simplify the language used around cessation, finding that ‘science discourse’ is ineffective (at least on its own) at putting the message across.

Effectively, it means that HPV – which is relatively common among the adult population – is more likely to become cancer in those who smoke. Tobacco users are less likely to naturally recover from a HPV infection (as most people do within around two years), increasing their risk of complications.

HPV prevalence also rises with smoking intensity, while quitting brings levels back down to that of never-smokers.

On top of the increased risk of HPV becoming cancer, Professor Nick adds: ‘Smokers also have poorer outcomes from treatment if they develop cancer increasing the risk of complications from surgery and decreasing the effectiveness of some treatments.’

What is Human Papillomavirus (HPV)?

Human Papillomavirus is a group of viruses that affect the skin and moist membrane linings of the body – including the mouth, throat and cervix.

There are more than 100 strains of the infection, and around 30 affect the genital area,

Genital HPV infections are very common and highly contagious – and spread easily during sexual intercourse, and through skin-on-skin contact of the genital area.

Most HPV infections are cleared by the immune system within two years, and don’t cause serious harm, aside from verrucas and skin warts.

Some strains cause genital warts, and abnormal tissue growth in the cervix, and can sometimes lead to cervical cancer.

While there is no treatment for the virus itself, medication is available for the effects.

For more information visit the NHS website.

When we think of passive smoking, we tend to think about how children or those with respiratory issues like asthma may be directly impacted by breathing the fumes into their lungs.

According to HPV Specialist Dr Alan King, though, ‘a woman’s chance of developing cervical cancer increases when her partner smokes.’

Although the risk is lower compared to women who smoke themselves, it’s another side to the damages of tobacco that we rarely consider, affecting everything from fertility to menstruation.

So how do we ensure that people are aware of the overarching negatives of smoking?

As mentioned above, cigarette packets have been a battleground for the war on tobacco, showing images of babies lighting up, men looking down at their (presumably impotent) genitals, and body parts mutilated by years of smoke.

Among the gore and shock factor, though, there are no warnings about gynaecological health issues.

‘It’s often overlooked that smoking damages the whole body,’ says Professor Nick.

‘There are 16 cancers known to be caused by smoking but also smokers are at greater risk of many other illnesses including heart conditions, diabetes, stroke, dementia.

‘Recent research has also identified links between smoking and the development of some mental health conditions such as depression and schizophrenia.’

He believes that the same strategies we’ve used to highlight the dangers of smoking so far can help further the public’s knowledge – and for those methods to be effective, they need to be properly funded.

Professor Nick says: ‘One of the biggest opportunities we have to communicate to smokers comes from health promotion adverts on TV, radio and elsewhere.

‘Over the last decade these have been chronically underfunded by Government despite being a highly cost-effective way to communicate to smokers and motivate them to quit.’

Cessation advice provided in a non-judgmental and helpful context is key to reaching the government’s smokefree goal, as is educating people about the breadth of smoking’s harms before they pick up their first cigarette. The challenge is reaching those that need help most.

‘Healthcare professionals also have a role to play,’ adds Prof Nick. ‘With smoking linked to so many conditions there are few occasions when it is not relevant to have a conversation about someone’s smoking and advise them of the best ways of stopping.’

As we continue to learn more about how our bodies react to different substances, the links between HPV recovery and tobacco usage will become more widely discussed.

Yet until this becomes common knowledge among smokers and non-smokers alike, some will continue to minimise the all-encompassing damage they’re doing with every puff.

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