Coronavirus is giving smokers incentive to quit, and social distancing could help them do it
The coronavirus pandemic is giving smokers more reasons to give up the habit, and it's creating a unique window of opportunity to do so.
As a medical doctor working in addiction psychiatry, I work with a lot of patients who smoke or vape. I've been hearing from many of them that the coronavirus pandemic is the extra motivation that they need to finally quit.
Some have told me they want to eliminate that trip to the corner store to buy cigarettes because they're worried about catching or spreading the virus. Others have lost jobs or have fewer work hours now and need to eliminate the expense.
Many of them tell me that they want their lungs to be as healthy as possible in case they become infected with the coronavirus.
The medical research coming in about coronavirus and smoking backs up those fears.
Why smoking can make COVID-19 worse
A study in China looked at the differences between early COVID-19 patients who were smokers and nonsmokers and found a higher percentage of smokers had severe COVID-19 illnesses compared to non-severe symptoms. It also found that of the people who were put on a ventilator or died, a higher percentage of smokers were in this group compared with the percentage of people who smoke in general.
There are many reasons why smoking or vaping nicotine or other products might make coronavirus illnesses worse. (There are a lot of people who vape non-nicotine products, thinking it's healthier. It's not.)
People who smoke are more likely to have heart disease and chronic lung conditions like COPD, and these conditions make the prognosis for the infection worse. People with chronic illnesses are more vulnerable to the effects of a type of inflammation caused by COVID-19 called a cytokine storm, which can damage blood vessels and lead to blood clots.
Simply the fact that smokers bring their hands to their faces, often touching or coming close to touching their face, can also increase the likelihood of infection.
European doctors who reviewed the data and research on connections between smoking and COVID-19 severity suggested that smoking may cause direct biochemical changes to the lung cells that can cause smokers to develop more severe illnesses from coronavirus infections.
Occasionally over the past few months, people have tried to promote tobacco use in the context of COVID-19. One study at a hospital in France found that a smaller percentage of COVID-19 patients were smokers as compared with the country's general population. That drew attention, but the study, published without peer review, has several weaknesses, including a small sample size that excluded the sickest patients—those in ICU—and probably underestimated the number of smokers who were hospitalized.
A unique opportunity to quit
Quitting is hard, even under normal circumstances. Many people say that smoking or vaping is a way they deal with stress, and these are stressful times.
On the other hand, smoking is often a social activity. With offices and factories closed and people away from friends and colleagues, old social patterns of smoking with friends and in certain places at certain times of day are disrupted. Social distancing can effectively take away the social aspect of smoking, particularly if no one else in the home smokes.
With less social pressure, smokers have a window of opportunity to work on quitting.
There are many online resources to support people who are trying to quit smoking, and taking advantage of these can be an opportunity to connect socially and develop a new support system during these times.
Nicotine Anonymous offers telephone meetings for people trying to quit smoking that follow the 12-step format, similar to the one used by Alcoholics Anonymous. Their website also has links to internet-based meetings and support lines.
There are also several apps for quitting smoking on the National Institutes of Heath website smokefree.gov that can be downloaded to a smartphone.
Teens in certain states, including Massachusetts, can get smoking cessation support through text or live chat through the website MyLifeMyQuit.com. The Massachusetts Department of Public Health operates the Quitworks program, which begins with either a phone call or an online referral and offers support.
Medications and telemedicine can help
Doctors can also prescribe different types of medication to help people quit smoking.
Nicotine patches are just one form of medication that can help someone to quit smoking. These patches are in the category of nicotine replacement therapy, which also includes nicotine gum and nicotine lozenges. Nicotine replacement therapy helps to reduce cravings by providing nicotine through a safer route.
Other medications affect the areas of the brain that make nicotine rewarding, so smokers are left with just the unpleasant effects of tobacco. These medications include varenicline, which binds to the nicotine receptor and activates it to reduce cravings. Another is bupropion, which reduces cravings for nicotine and may also help prevent the minor weight gain some people experience when they quit smoking.
Many doctors have added telemedicine to their practices during the coronavirus pandemic. Telemedicine provides a safe platform to develop a smoking cessation strategy with your doctor without leaving your home.
A few more tips
Once smokers and their doctors have decided on a strategy, there are some basic things they can do to increase their likelihood of success in quitting smoking.
Start by getting rid of the things that might trigger the urge to smoke, like lighters or ashtrays.
Tell friends and family that you are quitting so they can hold you accountable.