March 31, 2020, at 7:25 p.m.
This article is based on reporting that features expert sources.
DOESS
Smoking and Vaping
Make Coronavirus
Worse?
Smoking, vaping and illegal drugs lead the list of dangerous habits during the COVID-19 pandemic.
Can Your Habits Boost Coronavirus Risk?
By now most of us know
who is most at risk for a severe infection from the coronavirus. The Centers for Disease Control and Prevention states that, based on available information to date, those at high risk for severe illness from the coronavirus, or COVID-19, include:
• People age 65 and older.
• People who live in a nursing home or long-term care facility.
• People with chronic lung disease or moderate to severe asthma.
• People who have serious heart conditions.
• People who are immunocompromised, including those under-
doing cancer treatment, transplantation, poorly controlled HIV/AIDS and prolonged use of corticosteroids.
• People of any age with severe obesity (body mass index of 40 or above) or certain underlying medical conditions, particularly if
not well controlled, such as diabetes, renal failure or liver disease.
The CDC also says that pregnant women should be monitored. However, while pregnant women are known to be at risk with other severe viral illness, COVID-19 has not yet shown increased risk in pregnant women.
These are all risk factors that are hard or impossible to change. But are there other risk factors that fall more under our control? What habits should we all try to break to reduce the risk for a severe infection?
Smoking and Vaping Increase Risk
Perhaps at the top of the list of risky habits are smoking and vaping. This should come as little surprise: The coronavirus attacks the respiratory system, so anyone with damaged lungs would seem vulnerable.
At present, there isn’t much data on the relationship between smoking and COVID-19. One study, published online in the Chinese Medical Journal, found that, of 78 patients with COVID-19, those with a history of smoking were 14 times as likely to develop pneumonia.
There is also evidence that men in China are doing worse than women, and smoking – men smoke at much higher rates than women do – is proposed as the main reason for this discrepancy, says Dr. Jeffrey A. Linder, chief of the division of general internal medicine and geriatrics at Northwestern University's Feinberg School of Medicine. “Having damaged lungs and getting a lung infection is a double whammy,” he says.
That is proved by research into smoking and other respiratory illnesses. For example, a 2018 study in the European Journal of Public Health found that smoking increased the risk of influenza hospitalization and reduced the effectiveness of the flu vaccine in the elderly. And there is a large amount of research proving that smoking inflames the lungs and suppresses immune function. It also weakens the heart, another risk factor for severe disease.
There is even less research on vaping and lung diseases, but what is out there is frightening. “Vaping may be particularly harmful,” says Dr. Dean Drosnes, the medical director of the Pennsylvania campus of Caron Treatment Centers. “We are not sure, because the research is still new, but the aerosols that come out of vaping seem to harm pulmonary cells. So the potential is there that vaping makes someone more susceptible to contracting COVID because the cells can’t eliminate it, and may make the consequences worse because the lungs can’t clear the secretions,” Drosnes says.
These aerosols have been shown to increase tissue damage in animals exposed to influenza, he says, “and I extrapolate that to mean people too. Vaping may or may not be as bad as cigarettes, there is not enough research to unequivocally claim that, but it’s likely (the danger) is there. If you are looking to stop vaping, it’s a great time to stop.”
Smoking cannabis is also risky. The American Lung Association says smoking pot causes lung damage and may inhibit the immune system and increase the risk for airway infections. The more you smoke, the higher the risk, Drosnes says. “It’s a matter of how much you are forcing material into your lungs.”
Addictive Drug Use Raises Risk
As a specialist in addiction medicine, Drosnes has concerns about those who use these substances. “People with heart disease can have worse problems, and we know that methamphetamines, cocaine and alcohol abuse can cause heart disease. These all put people at higher risk,” he says. Methamphetamines also can cause respiratory problems by restricting the blood vessels in pulmonary tissue, he adds.
Those using opioids are in danger because these drugs slow down breathing, so these people “are not working their lungs like they should be.” Research has shown opioid use to increase the death rate in people with respiratory diseases.
In all, “there are very few substance-using patients who aren’t at higher risk,” he concludes. “We consider substance use a high-risk factor.
Drosnes clarifies that alcohol concerns apply to chronic, daily abusers. Casual alcohol use is most likely not a problem, the experts believe. “We are not advising people to totally abstain,” Linder says, only to follow the typical guidelines of no more than one drink a day for women and two a day for men. “Any more than that is not good for health – and that was true even in the land of a few days ago,” he says.
And if you are actually ill, avoid the liquor cabinet. “If you are sick, you don’t need to be drinking alcohol,” says Dr. Gary Leroy, a family physician in Dayton, Ohio, an associate dean for student affairs and admission and an associate professor of family medicine at Wright State University Boonshoft School of Medicine in Dayton, and president of the American Academy of Family Physicians. “You need an intact immune system to work to make you better.”
Lax Health Habits Raise Risk
Finally, it’s important to maintain all the habits that keep you and your immune system healthy anyway:
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“And make sure you have your regular medicines. Check with your doctor’s office to have an adequate supply in order to keep chronic diseases under control,” LeRoy advises.
David Levine, Contributor
David Levine has been covering a wide range of health topics, including mental and behavioral ... READ MORE
Sources
Jeffrey A. Linder, MD
Linder is a general internist and primary care clinician-investigator and the Michael A. Gertz Professor of Medicine and chief of the division of general internal medicine and geriatrics at Northwestern University's Feinberg School of Medicine.
Dean Drosnes, MD
Drosnes is a Fellow of the American Society of Addiction Medicine and serves on the ASAM Physicians-in-Training Committee. He is a member of the American College of Academic Addiction Medicine, the Pennsylvania Society of Addiction Medicine and the Alpha Omega Alpha Honor Medical Society. He holds an appointment as clinical assistant professor of Psychiatry at the Penn State University College of Medicine.
Tags: coronavirus, smoking and tobacco, vaping, lung disease, American Lung Association, patients, patient advice
2020
David Levine, Contributor
David Levine has been covering a wide range of health topics, including mental and behavioral ...
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