THE ASSOCIATION OF SMOKING AND RISK OF CONDYLOMA ACUMINATUM IN WOMEN

Objective: To determine the relation between cigarette smoking and the incidence of genital warts in a cohort of human immunodeficiency viru s (HIV)-infected women (without AIDS-defining conditions) (n = 148) an d in HIV-negative women (n = 428). Methods: Women were recruited betwe en March 1990 and December 1993 from an urban, inner-city medical cent er and nearby community health centers. Woman initially free of genita l warts (n = 576) were followed prospectively for up to 37 months, wit h an average of 14 months. Results: The observed incidence of genital warts per 100 person-years was almost three times higher in smokers th an in non-smokers, both in HIV-positive (13.3 versus 5.0, respectively ) and HIV-negative women (1.5 versus 0.5, respectively). In a Poisson regression model adjusting for variables significantly related to geni tal warts, including sexual activity, current smokers were 5.2 times ( 95% confidence interval 1.02, 26.0) more likely to develop genital war ts. The prevalence of human papillomavirus (HPV) by polymerase chain r eaction at baseline examination and the incidence of other sexually tr ansmitted diseases were similar in smokers and non-smokers. Conclusion s: Our findings are compatible with the hypothesis that the rate of pr ogression of symptomatic exophytic HPV disease is increased in smokers . Copyright (C) 1997 by The American College of Obstetricians and Gyne cologists.