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There's No Healthy Alternative to Smoking Except Quitting: Study

FRIDAY, June 26, 2020 (HealthDay News) -- Smoking is terrible for your heart and lungs, and simply switching to e-cigarettes won't do much good, a major new analysis finds.

That's especially true now amid the COVID-19 pandemic, experts added.

The only truly healthy way out for nicotine addicts is quitting, said a team led by Thomas Münzel, a cardiologist at University Medical Center in Mainz, Germany. His team found that both smoked and vaped nicotine was tied to worsening health of the heart and lungs.

"There is no doubt that smoking cessation is and will remain the most powerful approach to prevent smoking-induced cardiovascular and respiratory disease," the researchers concluded.

"This may be even more important in light of the … COVID-19 pandemic, as the use of tobacco products likely increases the risk for COVID-19-associated cardiovascular and other severe complications in smokers and vapers," the study authors added.

In the new study, Münzel's group reviewed data from a range of studies. They found that compared to not smoking, tobacco cigarettes and e-cigarettes boosted the odds of chronic obstructive pulmonary disease (COPD) by about eightfold and threefold, respectively.

COPD, a deadly, incurable combination of bronchitis and emphysema, is closely tied to smoking and is the fourth leading cause of death in the United States.

Compared to not smoking, tobacco cigarettes increased the risk of lung cancer by more than 13-fold, the study found. Because lung cancer takes years to develop, the level of evidence for the impact of e-cigarettes on lung cancer risk is not yet sufficient to draw a reliable conclusion, the investigators said.

There is good evidence for vaping's damage to the heart, however. Compared to not smoking, tobacco cigarettes increase "arterial stiffness" -- an important predictor for the risk of heart problems -- by 10%, while e-cigarettes upped the risk by 7%, the research showed.

The researchers also examined the link between smoking and COVID-19, and concluded that as "outlined by the WHO [World Health Organization], tobacco cigarette and waterpipe smoking may contribute to increased burden of symptoms due to COVID-19 compared to non-smoking, including being admitted to intensive care, requiring mechanical ventilation and suffering severe health consequences."

The bottom line, according to Münzel: "Although e-cigarettes appear to be less harmful than tobacco cigarettes, there is growing evidence that they also may cause side effects in the lungs, heart and blood vessels and that e-cigarette use may increase the risk of COVID-19 infection." He spoke in a news release from the European Heart Journal, which published the new findings June 26.

Two U.S. experts agreed that vaping is not a "safe" alternative to traditional smoking.

"Smoking tobacco produces long-range adverse effects -- COPD, coronary and vascular disease -- and the vaping craze brought serious cases of lung damage in young people," noted Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City. He was referring to the more than 2,500 people across all 50 states who were hospitalized in 2019 with life-threatening respiratory dysfunction tied to recent e-cigarette use. Fifty-four of those patients died.

Patricia Folan directs the Center for Tobacco Control at Northwell Health in Great Neck, N.Y. Reading over the new study, she agreed that "tobacco use in all forms places individuals at higher risk for developing several diseases and disabilities, often causing more severe consequences when exposed to infections such as influenza."

And Folan added, "With respect to COVID-19, Chinese researchers found that individuals who were smokers and developed pneumonia were several times more likely to have increased severity of disease from the virus with poorer outcomes. As more research and data emerge about COVID-19 and smokers, we may see additional evidence indicating increased suffering and severity of disease among this population."

Her advice to anyone hooked on any nicotine product? Quit.

"To quit all tobacco products, getting help from your health care provider in the form of counseling and cessation medications is one of the most important things you can do for general health, especially during the pandemic," Folan said.

More information

The U.S. Centers for Disease Control and Prevention offers a guide for quitting smoking.

SOURCES: Patricia Folan, DNP,director, Center for Tobacco Control, Northwell Health, Great Neck, N.Y.; Len Horovitz, MD, pulmonary specialist, Lenox Hill Hospital, New York City; European Heart Journal, news release, June 26, 2020

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