Doctor Fabián Oña talks about the importance of preventing tobacco consumption, especially when the pandemic complicates respiratory symptoms in smoking patients.
Tobacco can generate anything from hypertension to cancer, an evil that has not been eradicated from the world.
Fabián Oña Cisneros, professor at the Uisek School of Medicine and general technical coordinator of the Ministry of Health,
Q: How does tobacco affect the lungs?
Smoking, as we understand it in public health, is a historical problem, we have been fighting for years and we have not been able to overcome it. In the world, 8 million people die each year from this cause and tobacco is a trigger for many other diseases, such as hypertension, diabetes, respiratory diseases. Tobacco does not allow the lungs to carry out adequate gas exchange and this reduces the respiratory capacity of people and this, added, for example, to a sedentary lifestyle, greatly complicates the picture.
Tobacco by itself already generates multiple effects and now we have a problem that is the entry of unregulated tobacco for smuggling, there are multiple substances that make up tobacco and are harmful, including nicotine.
Q: Is smuggled tobacco considered more harmful?
Absolutely. We have a regulation that allows the use of cigarettes for adults; but these that are sold on the corners of Quito, without any regularization, not only that we are not certain of their origin, their quality, nor do they have a sanitary registry that in some way takes care of the health of the people of Quito, but also their sale is a problem, since they can buy minors, because we can’t have control over that. At least in stores they ask if the person is of legal age.
Q Do people who are smokers and have or have had covid have greater damage to their lungs?
When the pandemic started in 2020 we did not know much, we are even still learning about this disease. In the first studies of that year, which tried to relate the severity of the disease, they initially suggested that tobacco consumption could be a protective factor against covid. It was thought that since nicotine consumption affects one of the receptors through which the virus enters, the possibility of the virus entering the cell was reduced.
Then, in the United Kingdom, they did a large-scale study, with approximately 420,000 participants, and they did an observational epidemiological study. Here they concluded that tobacco is not a protective factor against the disease at all; in fact it is directly associated with the severity of the disease. And for those with a history of smoking, the prognosis is poor.
They reach four important conclusions: tobacco consumption is related to a higher risk of SARS infection, smokers have a higher burden of symptoms, have a higher viral load, and are at risk of worsening the condition.
Q Are the effectiveness of vaccines reduced in smokers?
First, let us differentiate that immunization by vaccination does not make the virus contagion worse, but it does not prevent contagion.
On the other hand, the consumption of tobacco, according to the study, increases the probability of contagion, so the smoker will have a greater risk of becoming infected, the vaccine does not free him from contagion. Even with a vaccine, being a smoker would worsen the picture, because the immunity process with smoking is not directly related.
Q Does the use of electronic cigarettes have an affectation relationship in the same way as tobacco?
There was a lot of ignorance of the people when considering that by suppressing the regular cigarette with the electric one, in some way, they were eliminating the problem. Even today there are some vapes that do not contain nicotine, some are just vapor.
But what the evidence tells us is that vaping, like tobacco, is harmful to health and that is why it has been suspended in 100% smoke-free spaces.
It is not that vaping does not have risks, in fact in the research that we reviewed, it says that vaping has the same or similar characteristics as tobacco in relation to covid. Even taking covid out of context, vaping has many respiratory conditions.
Q Is the affectation of a smoker directed only to the lungs? considering that covid has been seen to affect other parts of the body.
The affectations of the cigarette in a first phase is to the lungs, since they receive the contact. But it is a risk factor for many diseases, that is, it affects systemically. We are a cluster of systems, in addition to the respiratory system, if one is affected, the others are also affected. Cigarette is harmful in every way. And with the covid picture it gets even worse.
Q What are the post covid sequelae in smokers?
The consequences of covid, such as respiratory disease, are seen in the lungs that are injured, it is the most affected organ. The respiratory capacity of a patient who came out of covid is low, we have people who do not saturate more than 92, even though they are free of the disease. If tobacco consumption is added to that, the picture would be worse, not only would the oxygen saturation be affected, but it is going down even more, because the mere fact of smoking already decreases your lung capacity.
If you are a post covid patient, who was hospitalized and goes out to smoke cigarettes, you are destroying your evolution and health. A smoker after covid maintains the symptoms and cannot recover 100%, more so if they continue to smoke.
Q Is there a decrease in tobacco use since the pandemic?
There was reduction, but it was not entirely a decision but by access. In confinement it was difficult to access not only tobacco, but also other drugs.
Q And how to stop smoking?
Part of health promotion and prevention is understanding the enjoyment of life, strengthening protective factors and preventing problematic consumption from occurring. It’s not just about telling the person stop smoking, it is the fact of giving him alternatives so that he stops doing it. There you enter to differentiate between use, consumption, problematic use and addiction.
If it is addiction, it enters into a more clinical, psychiatric, medical process.
People who are using and consuming must be given other alternatives to stop smoking; there is a process for you to understand the damage it causes, including dealing with psychological issues, since there are people who smoke due to anxiety, depression, boredom.
If we get people to make informed decisions and know the effects of smoking, we will have a large number of people who will stop smoking on their own.
80% más probabilidad de ser hospitalizados tienen los fumadores con covid.
“A study records that people who smoke between 1-9 tobaccos a day have 2.14 times more risk of mortality from covid”. Fabián Oña Cisneros, professor at the Uisek Faculty of Medicine
