Sacramento – In 40 years of smoking, Katie Kennedy tried four times to quit, but always relapsed. Today, every time he feels like it, the same image appears: rows of patients with COVID-19 connected to ventilators.
Kennedy’s father also smoked. He was hooked up to a respirator before he died, and seeing how invasive the machine was and looking at his discomfort and anguish, Kennedy promised that he would not die like this.
“I decided it was time to protect my lungs,” said Kennedy, 59, who started a smoking cessation class in Sacramento in March. “COVID-19 is a great motivator.”
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Early studies suggest that smokers who develop COVID-19, the disease caused by coronavirus, are 14 times more likely to require intensive treatment compared to nonsmokers.
Free help
Doctors in California are taking advantage of this moment to highlight the connection between COVID-19 and smoking as another compelling reason to quit.
California’s toll-free help line for smokers, 1-800-NO-BUTTS, is redirecting research money to provide two weeks of free nicotine patches, shipped directly to the home of the person requesting them.
Calls to the helpline in March fell 27.5% compared to the same month last year, which the staff mainly attributes to people who are too stressed to consider quitting smoking. However, employees say that some of the callers refer to the coronavirus and being home as their inspiration to quit smoking.
“I spoke to a man last week who took this time very seriously to reorganize his life,” said Nallely Espina, a counselor at the helpline. “It helped him to be home and away from his smoking friends.”
A healthier life
A young man in his 20s called after reading an article about how even young people who smoke could have more serious health complications from the coronavirus, he said.
Approximately half of callers are using time at home to renew their habits: start practicing yoga, meditation, or a healthier diet. The rest seem extremely exhausted, trapped inside with their families.
Espina advises them that instead of going out to smoke a cigarette, go out and do some exercise.
California public health agencies are incorporating information about the link between smoking and the coronavirus on their social media and public outreach messages, building on a 30-year legacy of aggressive anti-smoking campaigns and policies.
The state was the first to ban smoking on planes and in restaurants and bars, adding a long list of other public spaces over the years that made smoking logistically difficult and culturally unpopular.
A relationship to study
As a result, California has the second lowest smoking rate in the country, at 11.3%, after Utah, where only 8.9% of the population smokes and Mormon values are credited with discouraging the habit.
While health advocates push smokers to quit, some researchers wonder whether California’s low smoking rate will influence how the state fares through the pandemic.
“It’s a great question,” said Ruth Malone, a professor emeritus of nursing at the University of California-San Francisco, who has studied tobacco control for 20 years.
“Smokers do much worse if they contract the virus, which is not too surprising given that it attacks lung tissue. There’s also new research that suggests it might even promote transmission because of the particular pathways it connects to. ”
Testing a correlation would require sophisticated models to isolate smoking as a risk factor from the many others that help determine geographic differences in the spread and severity of the virus.
Those factors include population density, when the virus entered a community, and the timing of mitigation measures, such as the order to stay home, which California was the first state to institute.
Tobacco affects the defenses of the lungs
Researchers have long known that smoking makes it harder to fight respiratory infections by increasing mucus production and paralyzing cilia, the hair-like fibers in the respiratory tract and lungs that normally kill off invaders.
“If any organism reaches the lower respiratory tract, be it the coronavirus or another virus, you have the mucus in which it can get stuck and cannot be eliminated because the cilia do not work”, explained Dr. John Swartzberg, professor emeritus of diseases infectious at UC-Berkeley. “Then those organisms find a perfect home.”
The latest science indicates that smoking may also increase a person’s chances of contracting the coronavirus, because tobacco increases a certain enzyme receptor in cells, the angiotensin-2-modifying enzyme, where scientists believe the virus binds and It infects, said Marcos García-Ojeda, an immunologist at UC-Merced.
Imagine a human cell like a house with doors and windows where the virus can enter, he added. “If you smoke, you increase the number of windows and doors for the virus to enter,” he said.
Nicotine as a help?
Still, other scientists hypothesize that the virus enters cells through a different receptor, one that nicotine can block.
Researchers in France plan to explore whether wearing a nicotine patch can help prevent infection, while acknowledging that smokers who develop COVID-19 are more likely to experience more severe symptoms.
Anti-tobacco advocates are asking the Centers for Disease Control and Prevention (CDC) to collect more robust data on the connection between smoking and the coronavirus. Developing a reliable and widely available coronavirus antibody test could also help to better observe that connection.
“Once you quit smoking or vaping, your lungs, your immune system, start to improve in a matter of minutes,” said Dr. Elisa Tong, a UC-Davis physician and project manager for the Tobacco Quit Network. University of California.
