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Strong call to ban tobacco smoking
View(s):Ban tobacco smoking in Sri Lanka.
This is the strong plea by Consultant Psychiatrist Dr. Amila Isuru in the light of the COVID-19 pandemic that has gripped the world including Sri Lanka.
Dr. Amila Isuru
As a country grappling with COVID-19 and thousands of lives being at stake across the world, we have taken commendable measures including a lockdown, curfew in high-risk areas, closure of ports of entry including the airport, shut down of universities and schools, social distancing, hand-hygiene and wearing of face-masks, he says, arguing for another measure which should be the banning of tobacco smoking.
In the face of the grave danger being posed by COVID-19, it is important to halt any factor which could cause the spread of this disease and prevent exposure of any person to the virus as an uncontrolled spread could lead to the saturation of Intensive Care Unit (ICU) beds and mass deaths, he warns.
This Psychiatrist who is attached to the Tissamaharama Base Hospital cites a large scientific study titled ‘Smoking is associated with COVID-19 progression: A meta-analysis’ published in May by the Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.
Smoking depresses pulmonary immune function and is a risk factor contracting other infectious diseases and more serious outcomes among people who become infected. This paper presents a meta-analysis of the association between smoking and progression of the infectious disease COVID-19, states the authors from the Center for Tobacco Control Research and Education, Department of Medicine, University of California, San Francisco, United States of America and the Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Having studied the PubMed medical platform on April 28, 2020, the authors had selected studies reporting smoking behaviour of COVID-19 patients and progression of disease for the final analysis. Applying a random effects meta-analysis, they had identified 19 peer-reviewed papers with a total of 11,590 COVID-19 patients, 2,133 (18.4%) with severe disease and 731 (6.3%) with a history of smoking.
A total of 218 patients with a history of smoking (29.8%) experienced disease progression, compared with 17.6% of non-smoking patients. The meta-analysis showed a significant association between smoking and progression of COVID-19. The limitations in the 19 papers suggest that the actual risk of smoking may be higher, they state, concluding that “smoking is a risk factor for progression of COVID-19, with smokers having higher odds of COVID-19 progression than never smokers”.
“Physicians and public health professionals should collect data on smoking as part of clinical management and add smoking cessation to the list of practices to blunt the COVID-19 pandemic,” the researchers add.
Dr. Amila, meanwhile, underscores that tobacco smoking affects many people medically, psychologically and socially in this time of the COVID-19 crisis, while huge profits are garnered only by the tobacco industry.
n Medical effects – Tobacco smoking lowers the immunity of smokers which leads to them being at a high risk for infections including COVID-19. This is because tobacco smoke damages the respiratory system’s structures and functionality. As such, if a smoker gets COVID-19 there will be a need for ICU management and that patient would also face a higher risk of dying.
The chances of a smoker having co-morbidities such as hypertension, ischaemic heart disease and stroke are more, which once again makes them at a higher risk of catching COVID-19, while the outcome of such an infection would be more severe and the chances of dying higher due to poor outcome.
Another interesting factor is that smokers have a habit of sharing the fag and this would help spread COVID-19.
n Psychological effects – in these turbulent times, people are facing severe financial difficulties as well as many social issues. Vulnerable people have a higher risk of developing anxiety and depression, with existing mental health issues worsening. There are many important studies which prove that smoking heightens mental health issues.
n Social effects – with families having limited budgets and money being hard to come by even to meet basic needs following huge pay-cuts, job layoffs and the crisis not settling in the near future, the precious little money they have should not be sent up in smoke but used for food, basics and medication.
Dispelling misconceptions being touted by the tobacco industry that the government earns much revenue through the imposition of taxes, Dr. Amila is quick to point out that it is not so.
“Such revenue through taxes on the tobacco industry is nothing compared to the large amounts of money the government spends on treating people who suffer the disastrous health consequences of smoking. This is in addition to the major dent made into such people’s family budget as well as loss of work hours due to prolonged smoking-related illness,” he says, adding that these are the funds the country can use for community development.
57 die due to smoking per day
The statistics are disturbing:
- 57 people die per day due to smoking in Sri Lanka, adding up to 20,000 deaths per year.
- A whopping Rs. 208 million is spent on cigarettes per day in Sri Lanka, which just fattens up the purses of the tobacco industry.
Can smokers quit?
There is a misconception that smokers cannot quit, but the reality is that 70% of people who have stopped smoking have done so without any medical help, says Dr. Amila Isuru.
Didn’t the non-availability of cigarettes due to closure of shops bring down the rate of smoking, he asks.
