Objective: To determine the relation between cigarette smoking and the incidence of genital warts in a cohort of human immunodeficiency virus (HIV)-infected women (without AIDS-defining conditions) (n = 148) and in HIV-negative women (n = 428).
Methods: Women were recruited between March 1990 and December 1993 from an urban, inner-city medical center and nearby community health centers. Woman initially free of genital warts (n = 576) were followed prospectively for up to 37 months, with an average of 14 months.
Results: The observed incidence of genital warts per 100 person-years was almost three times higher in smokers than 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 genital warts, including sexual activity, current smokers were 5.2 times (95% confidence interval 1.02, 26.0) more likely to develop genital warts. The prevalence of human papillomavirus (HPV) by polymerase chain reaction at baseline examination and the incidence of other sexually transmitted diseases were similar is smokers and non-smokers.
Conclusions: Our findings are compatible with the hypothesis that the rate of progression of symptomatic exophytic HPV disease is increased in smokers.