According to the Global Adult Tobacco Survey, more than a billion people use some form of tobacco worldwide. One in five adults indulge in smoking or smokeless forms of tobacco globally.
There has been one death in every four seconds related to tobacco use directly or indirectly worldwide. In India, around 1.3 million deaths accounted for tobacco use annually. More than fifty percent of smokers express a willingness to quit smoking on a regular basis but fail to do so.
Approximately 70% relapse within a week of quitting smoking. People who smoke regularly develop different kinds of respiratory infections, lung, head and neck cancers, cardiovascular, neurological complications etc resulting in high mortality. Currently, the world is witnessing a pandemic. It is very well-known that people with comorbid medical conditions, elderly population, and people who smoke, are at higher risk of infection compared to others. These findings have been consistent across the countries over the last few weeks.
Can smoking increase the chances of getting Covid-19 infection? Yes, because smoking reduces the local respiratory defences in the bronchial system of your lungs, decreases your immunity and makes you more prone to infection. By sharing cigarettes, you will get exposed to other individuals and a higher rate of hand-to-mouth contact can result in increasing your chances of spread of the virus. Smoking would also result in a higher rate of spread of infection to others by ‘smoker’s cough’.
Impact of smoking
It has been recorded that Covid-19 infections have been severe in people who smoke nicotine and the rate of admission to hospital/ICU admissions requiring ventilator is very high. The people who smoke are with secondary medical comorbidities putting them at further risk of higher mortality when affected with corona infections.
Individuals trying to achieve abstinence from nicotine usually struggle to tackle the triggers which leads to relapse. Few common triggers which are particularly of importance during Covid-19 times are social cues from peer exposure to smoke, frequent coffee breaks at the office, social gatherings like pubs, bars, restaurants, business events and celebrations, access/availability of nicotine at stores, frequent fights and disagreements at home due to smoking and exposure of children to smoke at home. These factors shall serve to successfully maintain abstinence in Covid-19 times because of major changes in everyone’s lives namely work from home (WFH), social distancing, extensive family engagement, shared domestic and parenting responsibilities etc. But there are other factors which could also lead to increase in smoking like social isolation for long periods, poor work-life balance, strained interpersonal relationships, lack of personal time, poor coping skills, pre-existing psychiatric conditions, financial and job insecurities etc.
Strategies to quit
The first and most important step is to identify the reason to quit. If the reason to quit is driven by internally motivating factors, there is a strong possibility to sustain the change. Try to use substitution strategies to achieve abstinence like nicotine gums, lozenges, patches, etc. Also, it is essential to build strategies not only to deal with the withdrawal symptoms but also to focus on managing stress by relaxation techniques like deep breathing, regular physical activity, building an active routine, frequent social engagement with family members, talking to someone about your emotions etc.
One should learn to practice mindfulness which will not only reduce the craving for nicotine but will also help to reduce stress and anxiety thus improving the mood. One should actively build a routine to engage themselves, appreciate the short-term achievements from abstinence which would build a positive sense of self.
The benefits of quitting smoking will begin immediately with reduction of carbon monoxide from the blood levels and improvement of oxygen supply in the initial few hours itself, with gradual improvement in the overall lung functions over the next few weeks. This would also
help to improve your immunity and protect you from the impact of Covid-19.
(The author is consultant psychiatrist, Department of Mental Health & Neuroscience, Fortis Hospitals, Bengaluru)