For many, the COVID-19 lockdown has been a good push to quit smoking. Tobacco smoking or chewing is a known risk factor for many respiratory infections and increases the severity of respiratory diseases. On World No Tobacco Day today, here is an article that highlights how smokers are likely to be more vulnerable to COVID-19 as they may also already have lung disease or reduced lung capacity which would greatly increase the risk of serious illness.

By Dr. M.S. Vishveshwara

As the global impact of COVID-19 increases, the healthcare community evaluates the clinical impact and the needs of patients with lung disease, who are at an increased risk of serious complications due to COVID-19. 

Recently a review of studies by public health experts convened by the World Health Organisation (WHO) found that smokers are more likely to develop severe disease with COVID-19 compared to non-smokers. 

India is home to a substantial number of tobacco users, frequently characterised by people who are consuming smoke and smokeless tobacco, the synergistic effect of it on lung health. People whose lung health is affected by factors such as lung disease or smoking tend to be at higher risk for more severe symptoms of COVID-19. 

Tobacco consumption is associated with adverse health effects and is the prime cause of deaths globally. The underlying logic of a link between smoking and worse COVID-19 outcomes is that smoking is an established risk factor for respiratory infections, including the flu because it weakens the immune response that a person can mount against viral infection. Smokers may also greatly increase the risk of serious illness. 

Suppressed immunity among smokers 

As COVID-19 is a virus that primarily attacks the lungs, anything that harms the lungs can and result in more severe effects if people do become infected. Smoking increases the risk for respiratory infections, weakens the immune system, and is the primary cause of chronic health conditions like COPD (Chronic Obstructive Pulmonary Disease), diabetes and heart disease. Their immunity is suppressed because the mucosal barrier is damaged because of smoking. These diseases are considered pre-existing conditions that contribute to COVID-19 complications.

Smoking and vaping harms the lungs, leaving lung tissue inflamed, fragile and susceptible to infection. And tobacco use has been proven to harm our immune system and airway-lining cells that contain cilia on their surface, which are our essential defenders against viruses like the novel Coronavirus. Without them working properly, the lungs may be left undefended against the virus and susceptible to the most severe complications of the infection.  

Signs and symptoms of unhealthy lungs

Signs and symptoms of lung diseases depend on the specific condition. They can vary from person to person and change over time. While each lung condition has its own features, there are some common signs and symptoms that are seen with many lung disorders.

•        Persistent cough

•        Shortness of breath

•        Wheezing, gasping for breath

•        Feeling like you’re not getting enough air

•        Decreased ability to exercise

•        Coughing up blood or mucus

•        Pain or discomfort when breathing in or out

Tests to diagnose lung disease

Lung function tests also called pulmonary function tests, measure the functioning of the lungs. Most of the tests involve assessing how much air a person can inhale and exhale. For instance, if a person exhales much less than the normal volume of air in one second or still has too much air in the lungs after exhaling forcefully; it may be a sign of lung disease.

Some of the common lung function tests are spirometry, body plethysmography, lung diffusion capacity, bronchial provocation test, cardiopulmonary exercise stress test, pulse oximetry test and arterial blood gas test.

Quit smoking to improve quality of life

Smoking impacts on a person’s health, finances, lifestyle and social interactions. Smoking also affects material well-being, personal life and the health of people around them. Quitting smoking is associated with an improvement in mental health in comparison to continued smoking. It is well- known that stopping smoking substantially reduces major health risks, such as the development of cancers, cardiovascular and respiratory diseases.

Smoking also leads to financial burden for smokers and their families. Cigarettes have become increasingly expensive over the years. Giving up smoking reduces financial stress and improves standards of living. Those who quit smoking report less financial hardship and greater well-being compared to continuing smokers.

In the time of COVID-19 pandemic, smoking also increases the risk of being infected by the virus. Hence it is advisable to practice infection prevention techniques and carefully follow the precautionary measures such as toll-free quit lines, mobile text-messaging programmes, and nicotine replacement therapies, which can take immediate steps to quit smoking.

It also reduces the risks of other health problems such as heart attacks and strokes. Quitting is also linked to reduced depression, anxiety, and stress and improved positive mood and quality of life.

[The author is Chief Radiation Oncologist and Medical Superintendent Bharath Hospital & Institute of Oncology, Mysuru]