Ending tobacco use will reduce risk of deadly diseases including COVID-19

Tobacco and lung diseases increase the risk of serious outcomes of COVID-19 including death
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Scientific evidence from COVID-19 hard-hit countries globally has shown that elderly people and also those with conditions such as non-communicable diseases are at a much higher risk of severe outcomes of COVID-19, including death. “Tobacco use is the biggest common risk factor of major NCDs such as heart diseases and stroke, cancers, diabetes, chronic respiratory diseases among others. Tobacco adversely affect the respiratory system and damages the lungs as well as weakens the immune system. Tobacco has a deadly connection with the world’s biggest killer infectious disease tuberculosis (TB), which heightens the risk of serious outcomes of COVID-19” said Prof (Dr) Surya Kant, Head of Respiratory Medicine Department of King George’s Medical University (KGMU). He said that people who have TB are usually more vulnerable to other infections, including the novel coronavirus, due to pre-existing lung damage. They are at a higher risk of developing complications from COVID-19.
Prof Surya Kant was a keynote speaker in the last Sustainable Development e-Talks (#SDGtalks) co-hosted by Indian Institute of Management Indore. These e-Talks were launched on World Health Day and will conclude on World Environment Day on 5 June, featuring three online sessions every week with thought leaders on sustainable development from around the world.

Prof Surya Kant said that according to Ministry of Health and Family Welfare, Government of India, 86% of deaths due to COVID-19 have exhibited comorbidity related to diabetes, chronic kidney issues, hypertension and heart related problems. Tobacco is a common major risk factor of all these conditions. Tobacco spitting in public places could enhance the spread of the COVID-19. According to Indian Council of Medical Research (ICMR), “Chewing/ smokeless tobacco products (Gutkha, ‘Paan masala’ with tobacco, ‘Paan’ and other chewing tobacco products) and areca nut (supari) increase the production of saliva followed by a very strong urge to spit. ICMR has urged to refrain from consuming smokeless tobacco products and spitting in public places. State Government of Uttar Pradesh in India had banned the sale of ‘paan masala’, in view of the alarming COVID-19 pandemic in March 2020.

The recent release of a report by the National Institute of Health in Italy stated that more than 99% of those who have died from COVID-19 had pre-existing medical conditions, including high blood pressure, heart disease, Chronic Obstructive Pulmonary Disease, and diabetes. Tobacco is a major common risk factor for all these listed conditions.

Prof Surya Kant has been the national President of all three key lung health professional associations in the country: National College of Chest Physicians, Indian Chest Society and Indian College of Allergy, Asthma and Applied Immunology. Prof Surya Kant said that recent data analysis of the COVID-19 deaths in Delhi shows that 45.28% of those who died due to COVID-19 were less than 60 years of age (54% were above 60). More important factor which can cause serious outcomes of COVID-19 including death are co-morbidities, in Delhi, 86.79% of those who died of COVID-19 had high blood pressure, diabetes, heart ailment or kidney disease – tobacco is a major common risk factor which is entirely preventable of all these conditions.

Right to breathe in clean air must be ensured for every person, stressed Prof Surya Kant. A blessing in disguise in this pandemic is that people are realizing the benefits of reduced consumption patterns which are manifesting with cleaner air quality for example. Even small increases in fine particulate matter, known as PM2.5, have had an outsized effect in the USA. BBC reported that an increase of just 1 microgram per cubic metre corresponded to a 15% increase in COVID-19 deaths, according to the researchers of Harvard University.

Prof Surya Kant added that air pollution also aggravates range of other lung diseases including asthma and dangerously increases the risk of lung cancer for instance.

Prof Surya Kant underlined the WHO’s writing on the wall: there is “no safe limit” to tobacco. With the looming danger of economic recession due to COVID-19, it becomes even more vital to avert the huge financial cost of tobacco use to the global economy. Prof Surya Kant said that “according to the World Bank, tobacco-related deaths are not only preventable tragedies but have an important economic cost. Worldwide, the total economic damage of smoking (including medical costs and productivity losses from death and disability) has been estimated at more than US$ 1.4 trillion per year, equivalent to 1.8 percent of the world’s annual Gross Domestic Product (GDP).” The economic evaluation report prepared by the World Economic Forum and the Harvard School of Public Health states that 5 NCDs (cardiovascular disease, chronic respiratory disease, cancer, diabetes, and mental illness) “could contribute a cumulative output loss of US$ 47 trillion in the two decades from 2011, representing a loss of 75% of global GDP in 2010 (US$ 63 trillion).”

Prof Surya Kant appealed to the government to consider stronger life-saving measures towards ending tobacco caused epidemic of diseases which also is now linked to fueling COVID-19. He called for turning this problem of COVID-19 into an opportunity to turn towards healthier lifestyle with balanced diet, quitting tobacco and alcohol and other addictions among other steps that will improve our mental, physical and spiritual wellness too.

23 May 2020