Call it quits

Smokers are at a high risk of succumbing to Covid-19 if they also suffer from diabetes, hypertension, or asthma, warns Dr Deepak Krishnamurthy

Making resolutions is like a ritual that brings a sense of optimism and a feeling of control in our minds. Be it getting fit, eating healthy or quitting smoking, these resolutions are promises to start anew and try to become the better and improved versions of ourselves. However, most of them are difficult to keep and are broken easily. Social science researchers call this the false hope syndrome where we set high, yet unrealistic expectations.

Despite the challenges, promising oneself to quit smoking is one of the most common, difficult and beneficial resolutions. And it’s all in the mind. India is home to approximately 120 million smokers. In the wake of Covid-19 pandemic, leading healthcare experts suggest that smokers are likely to be at an increased risk in comparison with non-smokers. Smokers have a history of suffering from severe respiratory illness caused due to inflammation in the airways, and Covid-19 can make it worse for them, thus suggesting that “now” is a particularly good time to kick the butt.

Smokers use fingers and possibly contaminated cigarettes which increases the likelihood of transmitting the virus from hand to mouth.

They may already be at risk of having a reduced lung capacity or may suffer from underlying lung disease. Further, the use of products such as common vapes or waterpipes can facilitate the transmission of Covid-19 in communal and social settings.

Covid-19 is known to directly impact the lungs by reducing its capacity and limiting the intake of oxygen, thus leading to Acute Respiratory Distress Syndrome (ARDS) and pneumonia. Smokers with diabetes or hypertension are also at risk of succumbing to Covid-19, alongside individuals with asthma or wheezing problems.

Why is it hard to quit smoking?

A single cigarette contains about 10-12 milligrams of nicotine, making you consume about 1.1 to 1.8 mg of nicotine every time you inhale one. Nicotine is a highly addictive substance, similar to cocaine or heroin. When you smoke, the nicotine gets mixed in the blood. When it reaches the brain, it releases dopamine, the feel-good hormone leaving you feel pleasant, calm and happy. When the dopamine depletes, you are back to your original state and begin to yearn for that fresh flow of nicotine.

Nicotine acts as a stimulant. People usually smoke to increase concentration. They have trouble focusing when they do not smoke. When you stop smoking for some time, your body starts showing symptoms such as anxiety, frustration, anger, tremors, depression, insomnia, distraction, etc. These unpleasant withdrawal symptoms of nicotine often lead smokers to take to smoking again.

Quitting isn’t easy. People usually turn to smoking as a coping mechanism, especially at stressful times. They usually cut down their intake before attempting to quit it all at once which often fails. During stress, it is better to try and flex other coping muscles. Counselling and medication can help redeem your chances to quit. On average, studies reveal, there are
at least 6-11 attempts before people actually succeed. People who quit for even a short duration, witness a quick improvement in their lung health. If you are planning to quit smoking, try the following:

Fix a date to quit smoking.

Go on gradually reducing the number of cigarettes smoked per day and one fine day quit completely.

It may take 3-4 attempts to quit smoking and hence don’t be discouraged if you fail in one attempt.

Take professional help from a psychiatrist for smoking de-addiction.

Involve in healthy habits like exercise and yoga/meditation.

Try to quit as a group if you smoke with your friends at work.

Do not restart after quitting.

Nicotine replacement therapy: It is a medically-approved method to help people quit. They come in the form of gum, lozenges, patches, and inhalers. Studies show that using nicotine replacement doubles your chances of quitting. It also helps reduce craving and withdrawal symptoms.

One may consider taking nicotine replacement when you are ready to
quit, need help with nicotine cravings or have withdrawal symptoms. You could also be ready to quit the habit but not the substance.

If we negate the malice of Covid-19, the time of crisis due to the pandemic can be considered as a time of opportunity.

(The author is senior consultant interventional cardiologist, Sakra World Hospital)