According to the WHO, there are an estimated 1.1 billion smokers globally and about 1 billion smoking-related deaths during this century alone. The majority of these deaths are from low and middle-income countries where the prevalence of smoking is high and still growing. India is home to about 11% of the global smokers and a sizeable portion of people using smokeless tobacco. According to the GATS 2 study done in India in 2016-2017 about 100 million adults smoke tobacco and twice that number of people use smokeless tobacco in one form or the other. Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD).
Smoking also increases the risk for tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid arthritis. In light of the current pandemic, an increasing number of studies are coming to the conclusion that smoking is a risk factor and that smokers are affected more severely compared to non-smokers. There exists a significant relationship between current smoking and severe Covid 19 patients with an approximate 1.5 fold increased risk of ICU admission, symptom severity, and mortality in smokers.
A few studies also indicate that cigarette smoking is a risk factor for post-Covid sequelae such as pulmonary fibrosis. Although the government has undertaken many public awareness campaigns regarding social distancing, wearing masks, and hand washing more emphasis needs to be placed on measures that can be taken to reduce the severity of Covid 19. Smoking cessation is an important intervention that helps in reducing the severity of this disease.
Reports from other countries like China and the US show that smokers who test positive for Covid 19 are twice or thrice as likely to be admitted to the ICU or die compared to the general population. Large swathes of our population are not offered access to proven interventions that help users quit tobacco such as public awareness campaigns, national smoking cessation programs, nicotine replacement therapies, and other approved medications.
Our goal has to be to improve the reach of these interventions to every corner of the country if we hope to achieve a tobacco-free India in the future.