<p>Aim To identify smoking prevalence and behaviour in clients who are human immunodeficiency virus (HIV)-positive and to enrol those wanting to stop smoking in a smoking cessation programme.</p> <p>Method A questionnaire consisting of 28 questions on smoking behaviour was developed. Over an eight-week period at the Immunology Clinic, Royal Prince Alfred Hospital, New South Wales, Australia, 68 clients were asked to complete the questionnaire; 23 were ineligible because they were non-smokers. Of the 45 respondents who completed the questionnaire, 39 were current smokers and six were ex-smokers. Twenty seven clients enrolled in the smoking cessation programme.</p> <p>Results Smoking behaviour did not change due to a diagnosis of HIV or living with HIV. Stress was the main reason for recommencing smoking. At the end of the programme, 22 per cent (n=6) had ceased smoking and 40 per cent (n=11) had reduced nicotine intake.</p> <p>Conclusion Smoking behaviour is complex and the reasons clients continue to smoke are multifactorial. Therefore, smoking cessation programmes should reflect this complexity.</p>