World No Tobacco Day is celebrated around the world every year on May 31. In 1987, the World Health Assembly passed Resolution WHA40.38, calling for April 7, 1988, to be "a world no-smoking day." In 1988, Resolution WHA42.19 was passed, calling for the celebration of World No Tobacco Day, every year on May 31.
Nicotine
The nicotine contained in tobacco is highly addictive and tobacco use is a major risk factor for cardiovascular and respiratory diseases, over 20 different types or subtypes of cancer, and many other debilitating health conditions. Every year, more than 8 million people die from tobacco use.
Tobacco and COVID-19
What are the possible relations between tobacco use and the COVID19 pandemic? Smokers face a 40 – 50% higher risk of developing severe disease and death from COVID-19.
Tobacco use may increase the risk of suffering from serious symptoms due to COVID-19 illness. Early research indicates that, compared to non-smokers, having a history of smoking may substantially increase the chance of adverse health outcomes for COVID-19 patients, including being admitted to intensive care, requiring mechanical ventilation, and suffering severe health consequences.
Smoking is already known to be a risk factor for many other respiratory infections, including colds, influenza, pneumonia, and tuberculosis. The effects of smoking on the respiratory system make it more likely that smokers contract these diseases, which could be more severe. Smoking is also associated with increased
development of acute respiratory distress syndrome, a key complication for severe cases of COVID-19, among people with severe respiratory infections.
Any kind of tobacco smoking is harmful to bodily systems, including the cardiovascular and respiratory systems. COVID-19 can also harm these systems. Evidence from China, where COVID-19 originated, shows that people who have cardiovascular and respiratory conditions caused by tobacco use, or otherwise, are at higher risk of developing severe COVID-19 symptoms.
Research on 55 924 laboratory-confirmed cases shows that the crude fatality rate for COVID-19 patients is much higher among those with cardiovascular disease, diabetes, hypertension, chronic respiratory disease or cancer than those with no pre-existing chronic medical conditions. This demonstrates that these pre-existing conditions may increase the vulnerability of such inpiduals to COVID-19.
Tobacco use has a huge impact on respiratory health and is the most common cause of lung cancer. It is also the most important risk factor for chronic obstructive pulmonary disease (COPD), which causes the swelling and rupturing of the air sacs in the lungs, reducing the lung’s capacity to take in oxygen and expel carbon dioxide, and the build-up of mucus, resulting in painful coughing and breathing difficulties. This may have implications for smokers given that the virus that causes COVID-19 primarily affects the respiratory system often causing mild to severe respiratory damage, which could result in fatality.
Effects of Smoking on the Circulatory System
The effects of tobacco smoke on the circulatory system include: raised blood pressure and heart rate, constriction (tightening) of blood vessels in the skin, resulting in a drop in skin temperature, less oxygen carried by the blood during exercise, ‘stickier’ blood, which is more prone to clotting, damage to the lining of the arteries, which is thought to be a contributing factor to atherosclerosis (the build-up of fatty deposits on the artery walls), reduced blood flow to extremities (fingers and toes) and increased risk of stroke and heart attack due to blockages of the blood supply.
There is an increased risk of more serious symptoms and death among COVID-19 patients who have underlying conditions, including cardiovascular diseases (CVDs). The virus that causes COVID-19 (SARS-CoV-2) is from the same family as MERS-CoV and SARS-CoV, both of which have been associated with cardiovascular damage (either acute or chronic).
There is also evidence that COVID-19 patients that have more severe symptoms often have heart-related complications. This relationship between COVID-19 and cardiovascular health is important because tobacco use and exposure to second-hand smoke are major causes of CVDs globally. The effect of COVID-19 on the cardiovascular system could thus make pre-existing cardiovascular conditions worse. Additionally, a weaker cardiovascular system among COVID-19 patients with a history of tobacco use could make such patients more vulnerable to severe symptoms, thereby increasing the risk for those patients.
Smoking and Immunity
Although carcinogens within tobacco and cigarettes are to blame for the increased risk of cancer, numerous other compounds act as pro-inflammatory and immunosuppressive agents, including nicotine, formaldehyde, ammonia, carbon monoxide, benzopyrenes, tar, acetone, hydroxyquinone, cadmium, and nitrogen oxides. Of these, nicotine is known to be immunosuppressive that can lead to decreased neutrophilic phagocytic activity as well as affect chemotaxis and cell signaling, in addition to inhibiting the release of reactive oxygen species (ROS) thus impairing the ability of neutrophils to kill pathogens.
Within the lungs, smoking triggers a cascade of inflammatory agents in which macrophages lead to tissue destruction and further release of inflammatory agents that lead to the persistent chronic inflammatory syndrome.For example, macrophages, when activated, release interleukin-1 (IL1), which leads to the stimulation and proliferation of helper-T cells (CD4+), which themselves activate killer-T cells (cytotoxic effector CD8+). The macrophages in smokers’ lungs have a reduced ability to phagocytose inflammatory agents and dying cells within the lung.
The effects of tobacco smoke on the immune system include greater susceptibility to infections such as pneumonia and influenza, more severe and longer-lasting illnesses, and lower levels of protective antioxidants (such as vitamin C) in the blood.
Smoking and the Respiratory System
The effects of tobacco smoke on the respiratory system include irritation of the trachea (windpipe) and larynx (voice box), reduced lung function and breathlessness due to swelling and narrowing of the lung airways and excess mucus in the lung passages, impairment of the lungs’ clearance system, leading to the build-up of poisonous substances, which results in lung irritation and damage, increased risk of lung infection and symptoms such as coughing and wheezing and permanent damage to the air sacs of the lungs.
Second-hand Smoke Exposure
Tobacco can also be deadly for non-smokers. Second-hand smoke exposure has also been implicated in adverse health outcomes, causing 1.2 million deaths annually. Nearly half of all children breathe air polluted by tobacco smoke and 65000 children die each year due to illnesses related to second-hand smoke. Smoking while pregnant can lead to several life-long health conditions for babies.
Tips to Stop Smoking
If you want to stop smoking, you can make small changes to your lifestyle that may help you resist the temptation to light up. Make a list of reasons to quit. Keep reminding yourself why you made the decision to give up. Make a list of the reasons and read it when you need support.
Think positive, you might have tried to quit smoking before and not managed it, but don't let that put you off. Look back at the things your experience has taught you and think about how you're really going to do it this time.
Make a plan to quit smoking. Make a promise, set a date, and stick to it. Think ahead to times where it might be difficult (a party, for instance), and plan your actions and escape routes in advance.
Consider your diet. Is your after-dinner cigarette your favorite? Some foods, including meat, make cigarettes more satisfying. Others, including cheese, fruit, and vegetables, make cigarettes taste terrible. So swap your usual steak or burger for a veggie pizza instead. You may also want to change your routine at or after mealtimes. Getting up and doing the dishes straight away or settling down in a room where you don't smoke may help.
Change your drink. Fizzy drinks, alcohol, cola, tea, and coffee all make cigarettes taste better. So when you're out, drink more water and juice.
Get moving. Identify when you crave cigarettes. A review of scientific studies has proved exercise, even a 5-minute walk or stretch, cuts cravings and may help your brain produce anti-craving chemicals.
Make non-smoking friends. When you're at a party, stick with the non-smokers. Get some stop smoking support. If friends or family members want to give up, too, suggest to them that you give up together.
Keep your hands and mouth busy.
When you're out, try putting your drink in the hand that usually holds a cigarette, or drink from a straw to keep your mouth busy.
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