LIMA — Smokers have a harder time fighting off respiratory infections and are at higher risk for developing chronic lung disease — two factors associated with severe cases of COVID-19, the disease caused by the novel coronavirus — which is why some doctors are encouraging smokers to quit now to improve lung function before they get sick.
Researchers are still trying to determine the extent to which smoking itself can be attributed to worse outcomes from COVID-19, after preliminary studies in the U.S. and China found a possible link between the two.
“We know they have chronic inflammation of the lower lung,” said Dr. Rob Crane, a clinical physician with The Ohio State University Department of Family Medicine. “The air sacs tend to be more irritated. The basement membrane, that bottom lining of the lung, tends to get more broken up. You have cilia cells that don’t function in their reactions as well. And most acutely, the moment you inhale nicotine, it paralyzes the little hair cells, the cilia, that are the sweepers of the lung cleanup system.”
Oxygen diminishes when the lungs are congested with junk and fluid.
“That’s what kills people,” Crane said. “That’s why you find doctors trying to reposition people; put them on their stomach or sitting up or turned on their side so they can get that fluid drained different places and allow some parts of the lung to continue to ventilate.”
Crane, who is involved in tobacco cessation efforts and is the founder of the Preventing Tobacco Addiction Foundation, is one of the doctors using the coronavirus pandemic to encourage smokers to quit.
“There could hardly be a better motivator now than the risk of a horrendous death,” he said. “There are deaths and then there are deaths. But this death, where you asphyxiate, where you drown in your own secretions and then you go onto a ventilator and you probably don’t get off — you can’t say goodbye to your loved ones; you die alone — that’s right up there with really bad deaths.”
There were about 34.2 million active smokers in the U.S. in 2018, which accounts for about 14% of the adult population, according to the Centers for Disease Control and Prevention. But smoking is more common in Ohio, with about 21% of adults considered active smokers in 2017.
Crane said lung inflammation decreases just days after a person quits smoking. While the lung is not healed entirely, Crane explained those improvements help decrease the chances for chronic illness like heart disease.
Whether those changes are enough to improve a person’s chances of survival from COVID-19 are less clear.
Dr. Nora Volkow, director of the National Institute on Drug Abuse, wrote earlier this month that COVID-19 “could be an especially serious threat to those who smoke tobacco or marijuana or who vape” because the disease attacks the lungs. Likewise, she warned people with opioid and methamphetamine use disorders may also be at higher risk.
But even if active smoking is not directly related to COVID-19 complications, Crane said there are other benefits to quitting, like decreased risk of chronic disease. He said the most effective methods include smoking cessation medications and nicotine substitutes.
Mackenzi Klemann is a reporter with The Lima News.
April 21, 2020