While any time is a good time to stop smoking, COVID-19 has made it difficult for smokers to seek professional advice and support. Difficult, but by no means impossible.
This op-ed is shared by Dr Omar Khan, an assistant professor at the College of Health and Life Sciences at Hamad Bin Khalifa University.
Our understanding of COVID-19, the severe acute respiratory syndrome caused by the novel coronavirus SARS-nCoV-2, remains a work-in-progress. As things stand, the overwhelming majority of the scientific community is focused on making sense of an infection that has brought the world to a virtual standstill. Their overarching objective is clear: to identify a possible vaccine or an equally viable and robust treatment regime.
Beyond the growing number of common symptoms, here is what we already know:
Of the 0.3 million deaths so far attributed to COVID-19, 98% of victims presented additional underlying health problems, including cancer and diabetes. Although fatalities have been reported across all age groups, senior citizens in particular have borne the brunt of the pandemic.
Pre-existing medical conditions and age are therefore two important risk factors for contracting COVID-19.
One fact that undeniably predates the current situation is that smoking remains one of the biggest healthcare challenges the world has ever known. Approximately 1.5 billion people – or one in five adults – indulge in a habit that is linked to almost 20% of global deaths per year. Beyond cancer and diabetes, smoking is a major cause of stroke, chronic obstructive pulmonary disease and bronchitis. As a result of weakened immune systems, smokers are also susceptible to infections and inflammatory diseases including tuberculosis and rheumatoid arthritis.
Most smokers are painfully aware of the severe health risks attributed to cigarettes and other tobacco products. Public health campaigns reinforce the benefits of giving up smoking, including lower blood pressure, the body’s return to ‘normal’ carbon monoxide levels, and a reduced risk of strokes. According to surveys, close to 70% of smokers want to quit their habit. However, not nearly enough succeeded.
Despite the well-documented health problems caused by smoking, the jury’s still out on how a smoker’s immune system will ultimately cope with COVID-19. Yet, given what we already know about both, quitting might just be the most appropriate action for a better and healthier life.
The act of smoking involves frequent contact between fingers and mouth, which both help to spread SARS-nCoV-2 to the respiratory tract, thereby increasing the likelihood of a smoker contracting COVID-19. What better time to realise an important and life-saving goal than in the midst of a severe respiratory-illness-driven pandemic?
Early signs are encouraging. A recent survey published by The Guardian suggests that more than 300,000 Britons have quit smoking during the pandemic. Following warnings that smokers are at increased risk of suffering severe COVID-19 complications, a smoking cessation clinic in Wales experienced a 51% increase in referrals.
In India, a survey conducted by IIFL Securities found that approximately 58% of respondents quit smoking following the implementation of the nationwide lockdown, which also restricted the sale of cigarettes. The same survey also reported that 73% of those who quit smoking do not plan to start the habit once lockdown is lifted. According to a study by Sri Lanka’s Alcohol and Drug Information Centre (ADIC), lockdown has contributed to a 48% reduction in the country’s tobacco consumption as well as 20% cessation.
Yet, as most ex-smokers will tell you, giving up requires a lot of dedication and professional support. And unfortunately because of the lockdown, both are currently in short supply, but by no means non-existent.
In the absence of individual and group activities, many smokers that remain determined to quit have either joined or formed online communities. These provide much-needed spaces to share experiences and morale-boosting stories. Homeworking and reduced hours also afford opportunities to seek as much online information as possible to support individual efforts. Resources include smokefree.gov, NHS Live Well and other web-based programmes.
While the doors of smoking cessation counsellors and specialists might currently be closed, this does not mean experts are out of bounds. In many instances, it’s still possible to seek help and advice via email or phone. Research suggests that smokers are four times more likely to quit with the help of local ‘stop smoking’ services and by making use of remote services, such as text messaging and social media. Finally, free downloadable apps allow smokers to devise their own strategies for quitting, chart how many cigarettes they have smoked or cut out, and record money saved.
Social distancing measures can also play a significant role in helping people to stop smoking during the pandemic. Being isolated from families, friends and colleagues has disrupted old social patterns of smoking, thereby eliminating conditions when people often light up. Reduced social pressure in the absence of gatherings – particularly in bars, cafes and restaurants – also affords smokers greater incentives to quit.
Despite the overwhelming evidence of the benefits, some would have you believe that the COVID-19 crisis is not the best time to quit smoking. Reports from France and China have provocatively suggested that despite both having a significant population of smokers, the number turning up at hospitals with COVID-19 symptoms is dramatically low. So determined are the French in this assertion that the Pasteur Institute has been encouraged by the health ministry to prepare clinical trials testing the efficacy of nicotine patches for treating COVID-19.
Encouraging as this development may seem, nobody should be hoodwinked into assuming that smoking prevents or lessens the effects of COVID-19. Put simply, the data is very preliminary and lacks sound scientific evidence to support assumptions made. Indeed, a recent review of studies by public health experts at the World Health Organization found that smokers are more likely to develop severe cases of COVID-19 than non-smokers.
Consequently, a larger population-based retrospective study is required to firmly establish the connection between smoking and COVID-19.
Until this happens, the use of tobacco or nicotine products to treat or prevent COVID-19 remains a matter of speculation rather than fact. If anything, confirmation of perceived benefits should be reason enough to quit smoking and focus on nicotine replacement therapies including patches and gums. Not only are these much healthier options, they also underscore overwhelming evidence that smoking causes serious health problems, pandemic or no pandemic.