Tobacco cessation: Don't let your plans go up in smoke

Coverage of COVID-19 has dominated health news for more than a year now. But another disturbing health trend in 2020 has quietly slipped under the radar. During the pandemic, many vows to quit tobacco use went up in smoke.

Prior to the pandemic, cigarette sales had declined, year after year. When COVID-19 hit, that trend stalled. Calls to smoking cessation lines dropped 27% compared to 2019, and cigarette sales ticked up after four years of annual decline.

Given that smoking is the leading cause of preventable death in the United States, this resurgence stands as yet another one of the pandemic’s alarming side effects.

Years of evidence makes one thing clear: this resurgence is serious cause for concern.

• Each year, 480,000 people in the United States die from smoking-related illnesses. These include heart attacks, strokes and emphysema, one of the chronic obstructive pulmonary diseases (COPD.) The CDC reports that currently 16 million Americans live with a smoking-related disease.
  
• According to the CDC, current smokers and people with a history of smoking may be at a higher risk for severe coronavirus disease.
• Though much more needs to be revealed about the relationship between smoking and the coronavirus, there’s plenty we know now: Smoking is a proven risk factor for cardiovascular disease and lung disease, including lung cancer, which – along with other factors – can put you at higher risk for a severe case of COVID-19.
• In a meta-analysis of studies of COVID-19 patients, researchers found that the risk of disease progression in those who currently smoke or previously smoked was nearly double that of non-smokers. They also found that when the disease worsens, current or former smokers had more acute or critical conditions, and they ran a higher risk of dying from the virus.
• Evidence suggests that secondhand smoke and vaping can actually contribute to the virus’ spread. Smokers and e-cigarette users alike must remove their face masks when they smoke or vape. Between puffs, infected individuals will exhale contagious droplets and aerosols into the air, which could be inhaled by others nearby.
• In addition to being more vulnerable to COVID-19, many smokers and vapers have pre-existing lung conditions that leave them more vulnerable to getting the flu, pneumonia or bronchitis. Smokers have more ACE2 receptors (proteins on the surface of the lung cells), which makes it easy for infections from viral invasion to take hold.

To be clear, cigarettes and cigars aren’t the only culprits. Growing evidence suggests that smoking and vaping both weaken the lung defense, which could make it harder to fight COVID-19, especially for smokers with chronic obstructive pulmonary disease.

COVID-19 has starkly demonstrated the variety of ways smoking takes a toll on the immune system, lungs and heart. If all continues to go well and more American’s get vaccinated, the pandemic’s threat will eventually recede. The long-term damage caused by smoking won’t – not unless Americans once again kick the habit.

The good news for those who use tobacco is that it’s never too late to recommit to a healthy lifestyle.

Health and quality of life begin to improve quickly once smoke cessation begins. As early as one day after the last cigarette use, the risk of heart disease begins to diminish. The sense of taste and smell grow more enhanced after two smoke-free days. The lungs’ healing process begins within a month.

The health benefits of smoking cessation accumulate exponentially as the smoke-free months and years pass. One recent study found that quitting smoking not only prevents future lung damage – it could allow healthy cells to begin repairing previous damage.

The benefits of smoking cessation extend well beyond the individuals who quit using tobacco. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) recognizes that supporting a smoke-free lifestyle improves quality of life and reduces health care costs for all our members. By lowering the risk of chronic disease, smoking cessation programs help reduce stress on medical facilities and lower health care costs for everyone.

Studies estimate that smoking’s economic impact in the US totals more than $300 billion a year. About $170 billion goes toward direct medical care for smokers. Lost productivity because of premature death and secondhand smoke accounts for more than $156 billion. One national study estimated that a 10 percent reduction in smoking would lead to an estimated $63 billion reduction in total national health care costs in just one year.

In short, the increased trend in smoking is dismaying on many levels – for individuals and their families, for communities and for our nation.

Reversing this unexpected uptick in smoking will require serious effort.

The best way to stop smoking is to talk to your health care provider, make a plan and explore strategies that will help you stick to it. Your primary care physician can direct you to many of the support resources available, including behavioral therapy and medications.

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) members have access to Quitline NC, and most members can get free nicotine replacement therapy by enrolling in the 4-call QuitlineNC program. Nearly half (45.5%) of those who combine QuitlineNC counseling and 12 weeks of nicotine replacement therapy successfully quit smoking.

In addition, many members have ready access to Pivot, a game-changing smoking cessation program, at no additional cost. This app-based tool gives smokers round-the-clock access to a dedicated trained tobacco expert, nicotine replacement therapy, a personal breath sensor, and an online community of support. Initial studies found that 42% of program users successfully quit smoking in the initial survey period. After seven months, 86% of those who had quit remained smoke free. Almost 80% of Pivot users decreased their daily number of cigarettes.

Quitting smoking can be challenging, but the rewards are life changing. I’m hopeful that, as the pandemic’s thread recedes, more will recommit to going smoke free as a vital step in any health regimen.

If Americans take action now, we can ensure that an increase in smoking-related illnesses doesn’t add to the growing list of ways this pandemic will impact our nation’s well-being for many years to come.