Covid-19 changes our lives, maybe forever, and extraordinary efforts are being made to save lives. Smoking and stopping vaping must be part of this effort because, already, the data clearly show the effect of smoking on diseases caused by Covid-19.
Smoking causes damage to the lining of the lungs and impairs breathing function. Impaired respiratory function is a major element of the Covid-19 attack mechanism in causing the development of disease and severe death. If you are a smoker, you have a far greater risk for severe illness and death from the corona virus than for nonsmokers or ex-smokers.
Published studies of Wuhan in China shows that smokers with Covid-19 respiratory disease have a worse prognosis than non-smokers; have a higher prevalence of more severe disease; higher prevalence of disease progression; higher need for use of intensive care units (ICU); higher ventilation requirements; and more likely to die.
And the difference is not trivial.
In one study of 1,099 Covid-19 patients who were hospitalized in Wuhan, 31.7 percent of patients who smoked had a severe illness compared to 14.5 percent who had never smoked, who had a risk ratio almost doubled. Smokers have almost quadrupled progression to a worse state (16.2 percent compared to 4.7 percent): this worse condition goes to the ICU; use of mechanical ventilation; or die. There are also other similar scientific studies published, with smaller numbers, but similar findings.
In the US, questions about vaping as a cause of the high prevalence of disease in young adults have been raised but complete data to confirm this are not yet available. Not surprisingly, because we know smoking and yawning are related to the inflammatory process in the lining of the lungs, where Covid-19 causes the most serious disorders and damage.
The 16th anniversary of Smokefree Ireland is March 29. Life-changing times mean a lot to smokers and those exposed to cigarette smoke, a landmark for international tobacco control. Ireland was the first country in the world to introduce a national ban on smoking at work, in pubs, clubs, restaurants and bingo halls.
It is comprehensive, does not allow expensive weather, business measures, or artificial ventilation, and it works.
We know it works because our pubs become smoke free, bar workers’ health improves, and fewer people die from cardiovascular disease, respiratory ailments, and strokes.
Smoking becomes abnormal and the prevalence of smoking falls. Autumn has been most striking to our young people. Smoking fell from 33 percent in 2003 to 14 percent in 2019 among 16-year-old students. Smoking is also very low among adults, around 17 percent.
The success of the Irish cigarette smoke law as a policy initiative did not happen by accident. It was a success because of time, service, planning, implementation, and the presence of strong leadership and a strong, confident, and credible political champion.
When we analyzed what had happened, we found that a well-coordinated and broadly coordinated advocacy coalition with a unified voice and a clear focus on health was crucial in raising public awareness of the problem, fighting opposition arguments and ensuring political support. for the cause.
At Covid-19 we are fortunate to have a clear, authoritative, consistent and united voice from Department of Health, HSE, and impressive and capable politicians who work in harmony.
Unlike Smokefree Ireland, there is no significant opposition to what is being done. We have an approach that can be implemented and can be applied to protect everyone equally from the effects of viruses.
However, there is one big difference – time, the need to respond so quickly. Although planning for this type of emergency is part of health planning, this pandemic develops very quickly and the structure of the challenges does not become clear immediately.
China gave us time and quickly identified and shared the genetic structure of the virus but more needs to be done. As in 2004, in 2020 we need to engage with “street-level bureaucrats, namely industry and worker representatives, to ensure a basic level of support for interventions that we know can work if implemented but, as we find with Smokefree, implementation plans must must be followed carefully, compliance must be monitored consistently and continuously, and laws that are supported by substantial penalties if necessary, are aimed at a handful of careless people.
Smokers must know and be reminded that they will also help others by reducing the demand for scarce resources
What can stop the contribution of smoking? The message is clear. Smoking is a risk factor that can be avoided for a worse prognosis in Covid-19 infection, including death. Quitting smoking is an intervention that can help. Access to personal protective equipment (PPE), ICU capacity, and mechanical ventilation are the most scarce resources, and interventions that can make a difference when a small proportion of very severe cases arrive at the hospital. There is very little we know that can be changed which can reduce the demand for ICU beds unless quitting smoking.
Now is the ideal time to make a national effort to stop smoking and treat nicotine dependence. Many smokers, like others, do not work, are willing and, if told, want to quit smoking. They are also more likely to do so knowing that it will help save their lives, not only in the long run but now. They must know and be reminded that they will also help others by reducing the demand for scarce resources.
We must strongly encourage smoking cessation and cessation of vaping and provide a national treatment plan, free of charge, for all smokers and vapers and do it now. This is the best time to take it Irish Government the policy on tobacco endgame seriously and do it. Consultant respiratory doctor, Prof. Luke Clancy, is general director of the TobaccoFree Research Institute of Ireland
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