The World Health Organization has designated 31 May as ‘World No Tobacco Day’. This year’s theme is ‘Commit to quitting’, which is gaining significant importance in the current times of the COVID-19 pandemic.

The link between smoking and the COVID-19 infection has been controversial. Initial studies from China and Europe have apparently suggested a lower incidence of COVID infection among smokers and the protective effects of smoking against the effects of COVID. Subsequent analysis, however, showed serious methodological errors in those studies. And later studies have shown that smokers actually do poorly after a coronavirus infection.

COVID infection and lung complications in smokers

COVID mainly affects the lungs and smoke also damages the lungs. Global research suggests that there is a higher incidence of serious lung complications after COVID in smokers compared to non-smokers. The World Health Organization released a scientific commission earlier this year showing that smokers are at greater risk of developing serious illnesses and deaths due to COVID-19.

These findings of a negative impact of smoking should not be surprising, given that smokers are traditionally known to be more susceptible to infections, especially respiratory infections such as flu, pneumonia and tuberculosis.

Weakened immune system and increased risk of transmission

Tobacco smoke contains toxic chemicals that cause damage to the linings of the airways and lungs. The chemicals in tobacco smoke suppress the activity of different types of immune cells leading to weakening of immunity and thus impairing one’s ability to fight the COVID-19 infection.

The act of smoking involves the fingers and possibly infected cigarettes coming into contact with the lips, thus increasing the risk of transmission of virus from hand to mouth. In addition, paw tobacco products are commonly associated with saliva in public places, which also accelerates the risk of COVID transmission through saliva droplets.

Smokers are also more likely to have heart disease, stroke, cancer, chronic lung disease and diabetes, all of which are important comorbidities for the development of serious diseases and the adverse effects of the clinical outcome in patients affected by COVID.

Therefore, it is imperative that smokers quit the habit. And the COVID pandemic could not be a better time to quit smoking. However, this can be a challenge given the economic and social tensions that prevail during the pandemic. Smokers will need help to quit. And the WHO World No Tabacco Day 2021 campaign aims to empower and support tobacco users on their journey to quit.

There is no single and easy way to stop tobacco, but here are some tips

路 Make a ‘keep plan’ and stick to it. It does not matter if you fail a few times. Keep trying and do not give up.

路 Change your diet. There are certain food items that make cigarettes taste better such as meat, alcohol, tea, coffee and aerated beverages. Avoid it and instead use fruits, vegetables, cheese, water and fresh fruit juices. Also, if you have a habit of using cigarettes after meals, then change your routine and do some activity to distract your mind.

路 Have a support group in place to help you with this – family, friends, doctor, counselor.

路 Nicotine replacement therapy such as chewing gum or skin patches can be very helpful in overcoming your withdrawal symptoms.

路 Try to avoid stressful situations during the first few weeks after you have stopped smoking.

Exercise, even a 5 minute walk or stretch, has been shown to reduce your cravings and relieve some of your withdrawal symptoms.

路 Try to be close to your non-smoking friends and avoid your smoking buddies for a while.

路 Clean your house, your environment, clothes and belongings so that you do not get the familiar smell of cigarette smoke that will remind you of smoking.

The following are the answers to some common questions about the dangers of smoking:

What are the unique dangers of smoking for women?

Although smoking is bad for both sexes, women experience certain additional adverse health effects, apart from those common to all sexes. Some of these include:
premature menopausal menstrual disorders reduce fertility increased risk for cancers specifically for women such as breast or cervical cancer premature ‘aging’. Smoking during pregnancy exposes the fetus to toxic substances that can cause several complications, including abnormalities in the newborn baby or even miscarriages.

What are the long-term and short-term health effects of smoking among young people?

The short-term effects of smoking include throat irritation, cough, asthma, wheezing, unhealthy dental and oral hygiene. This is due to the carcinogenic substances such as nicotine, tar and carbon monoxide found in tobacco.

The long-term effects of smoking are more dangerous. Smoking has been shown to be strongly associated with a number of life-threatening diseases such as a variety of cancers, diabetes, respiratory disorders and cardiovascular diseases such as heart attack and stroke. Vision problems and infertility issues as well as weak immune systems are also more common in smokers than non-smokers. In general, smoking is associated with a lower life expectancy.

In terms of mental health, while smoking is commonly known to relieve stress and help people relax, it has been shown to increase anxiety levels, and smokers are at greater risk of clinical depression. For people who are addicted to nicotine, the fog of a smoke can cause irritation and mood swings and get in the way of normal functioning. Loss of appetite and disturbed sleep cycles are also frequently observed in smokers.

Can smokers and tobacco users be at greater risk for COVID 19 infection?

The link between smoking and the Covid-19 infection has been controversial. Initial studies have apparently suggested a lower incidence of Covid infection among smokers and the protective effect of smoking against the effects of Covid. Subsequent analysis, however, showed serious methodological errors in those studies. And later studies have shown that smokers actually do poorly after a Covid infection.

Smokers may be more susceptible to Covid-19 infection and the associated serious lung complications for the following reasons:

Tobacco smoke contains toxic chemicals that cause damage to the lining of the airways and lungs and suppress the activity of various types of immune cells, thus impairing one’s ability to fight the Covid infection.

The act of smoking involves the fingers and possibly contaminated cigarettes coming into contact with the lips, thus increasing the risk of transmission of virus from hand to mouth.

Smokers are more likely to have heart disease, stroke, cancer, chronic lung disease and diabetes, all of which are important co-morbidities for the development of serious diseases following Covid infection.

What is the effect of quitting smoking on the body?

The beneficial effects of quitting smoking begin almost immediately within minutes to hours and are still seen over a few years to a decade.

Within 30 to 60 minutes, heart rate and blood pressure begin to drop.

After about 12 hours, the carbon monoxide level in the blood drops to normal.

By 4-12 weeks, blood circulation and lung function improve.

By 3-6 months, cough and shortness of breath decrease and the risk of respiratory infections also decreases.
At 1 year, the risk of coronary heart disease decreases to about half that of a smoker.

At 5 years, the risk of a heart attack or a brain stroke risk was reduced to that of a non-smoker.

At 10 years, the risk of lung cancer drops to about half that of a smoker and the risk of cancer of the mouth, throat, esophagus, etc. also decrease.

Although in the first days after quitting you may have withdrawal symptoms, but in the long run quitting smoking will lead to less mental irritability, anxiety, depression and moodiness.

Abstinence from smoking also reduces the chances of impotence, infertility, premature birth and miscarriage.

And lastly, quitting smoking improves life expectancy.

Tips for effectively quitting smoking

There is no single and easy way to quit tobacco. Some of the following tips can help you kick off this habit:

Make a stop plan and stick to it. No matter if you fail a few times. Keep trying and do not give up.

Change your diet. There are certain food items that make cigarette taste better, such as meat, alcohol, tea, coffee, aerated beverages. Avoid it and instead use fruits, vegetables, cheese, water, fresh fruit juices. Also, if you have a habit of using cigarettes after meals, then change your routine and do some activity to distract your mind.

Have a support group in place to help you with this — family, friends, doctor, counselor Nicotine replacement therapy such as chewing gum or skin patches can be very helpful in overcoming your withdrawal symptoms.

Try to avoid stressful situations during the first few weeks after you quit smoking.

Exercise, even a 5-minute walk or stretch, has been shown to reduce your cravings and relieve some of your withdrawal symptoms.

Try to be close to your non-smoking friends and avoid your smoking buddies for a while.

Clean your home, your environment, clothes and belongings so that you do not get the familiar smell of cigarette smoke that will remind you of smoking.

The author is a senior interventional cardiologist at the Asian Heart Institute.

Updated Date: 31 May 2021 11:35:11 IST