It is never too late to stop smoking

Figures from a UK survey by Portland Communications show that just under half of smokers interviewed wished to stop in the New Year. Yet sadly almost 70 per cent had lit up within the first week of January, with over half smoking more than they were before their decision to quit.

With many more people working from home, this not only raises the risks to individuals themselves, but also those in the same household. Smoking claims a startling 100,000 lives every year in the UK, with the main causes of death being lung cancer, chronic obstructive airways/pulmonary disease (COPD) and ischaemic heart disease (IHD).

The charity ASH (Action on Smoking and Health) calculates another 11,000 deaths last year were as a result of exposure to second hand smoke, a noticeable proportion of these being in younger adults.

Articles on smoking sometimes, often unintentionally, victimise smokers, and I wish to be entirely clear that my desire in writing this piece is not to do so. Rather, I hope to present current evidence and perhaps suggest ways for those thinking about quitting to make steps towards that goal.

Since the 1970s there has been a rapid decline in the numbers of individuals smoking

Statistics on smoking show that since the 1970s there has been a rapid decline in the numbers of individuals smoking, down from half of the adult population to one in six, a figure that should be highlighted and celebrated.

So now is the perfect time to think about kicking the habit if you can. Most people are aware of the deleterious effects of smoking on every aspect of our being, yet showing pictures of charred lungs, or persons in the throes of a stroke has not been shown to increase desire to stop among smokers, such that many tobacco companies have abandoned this in favour of plain packaging.

Those wishing to quit any vice have to be “in the zone”, to quote an often-used phrase. There has to be a reason for stopping, be that the desire for better health and wellbeing or the realisation of the actual cost of the habit, which will run into several thousand pounds a year for tobacco. Encouragement from those around and literature emphasising the benefits of smoking cessation may prompt positive steps.

There has been the suggestion that smoking is protective against Covid-19. Not only is it disappointing that data could be misrepresented to construe this, it is also untrue. Covid-19 attacks the lungs and the blood vessels. It gains access to to cells in the lungs through a receptor on their surface called ACE-2. There are more of these receptors on the lungs of those who smoke, thought to be as a result of exposure to nicotine.

Smokers are more susceptible to respiratory infections such as Covid-19 and may develop a more severe case of illness. Those who have smoked for a significant period of time are already likely to have some damage to their lungs and blood vessels, so the added insult of Covid-19 may produce a more serious presentation and worse outcome than in those who have never smoked or who are ex-smokers.

Smokers are more susceptible to respiratory infections such as COVID-19 and may develop a more severe case of illness

The issue of e-cigarettes, also referred to as vaping, remains contentious. While feeding the desire for nicotine, they do not contain tar or produce carbon monoxide, two of the deadliest compounds found in traditional cigarettes. They too cause upregulation of ACE-2 receptors on the surface of lung cells, and this together with the hand to mouth action required to use the product, may increase the chances of contracting coronavirus. However, this must be balanced against the large body of evidence showing that e-cigarettes are much less harmful than smoking tobacco. Please note this is not the same as harmless.

A well-publicised major UK trial in 2019 showed that together with support from trained counsellors, e-cigarettes were twice as likely to result in smoking cessation compared to traditional methods of nicotine replacement therapy, for example patches and gum.

We don’t need nicotine to survive, yet it produces addiction rapidly, such that stopping can cause significant withdrawal symptoms, ranging from abdominal pain to nausea, vomiting and insomnia. These are often the reason well meaning individuals recommence smoking, despite their best efforts. The mission statement of one of the largest producers of e-cigarettes acknowledges “Nicotine is addictive and can cause certain harms to health”, and that “Those who don’t use nicotine should never start”.