33 - COVID-19 and Smoking (Mary Jo Henry, ARNP)

Mary Jo Henry, ARNP, joins Dr. Arnold to discuss smoking and its potential to make COVID-19 cases more severe.

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Transcript

Dr. Arnold:

This is LiveWell Talk On...COVID-19 and Smoking. I'm Dr. Dustin Arnold, Chief Medical Officer at UnityPoint Health - St. Luke's Hospital. Smoking and vaping are not healthy choices to begin with, but early data shows that there may be a link between smokers and severe cases of COVID-19. Joining me to talk more about this topic is Mary Jo Henry, Tobacco Treatment Specialist at UnityPoint Clinic Multispecialty. Welcome.

Mary Jo Henry:

Thank you. Good to be here, Dustin.

Dr. Arnold:

I think we're going to cover today, certainly, let's just touch a little bit on COVD-19. We'll have upcoming podcast. Feedback from the one that we did, maybe two weeks ago, was really strong. I mean people really, we got some facts in there, but we know that greater risk with COVID-19 infection is elderly with high risk clinical conditions; diabetes, smoking, well diabetes, chronic lung disease, which majority of the time is work-related smoking. But there appears to be a little nuance in the early data out of China that perhaps smoking by itself could be considered a chronic medical condition that would trigger a severe infection. Does that seem consistent with what you preach and practice?

Mary Jo Henry:

Yes. And as you said, I, we, this is all early data and we have to remember that. But yeah, I think that's something I'm concerned about and I think it's concerning and enough concern that we need to keep it in mind and keep thinking about it and urging people not to smoke.

Dr. Arnold:

Yeah. That's good advice on any day of the week.

Mary Jo Henry:

Absolutely.

Dr. Arnold:

Let alone a COVID.

Mary Jo Henry:

Right.

Dr. Arnold:

You know, I think we've translated this concern into identifying those patients just if they're, if they are hospitalized and just putting that in the back of their mind that even though they might not have chronic lung disease at baseline, but they are a chronic smoker, that indeed it may put them at a higher risk to have a more severe illness and require critical care. Since we last talked, I had been reading everything about COVID-19, but as we've distanced ourselves from the vaping injuries this summer, what did we learn there?

Mary Jo Henry:

Vaping?

Dr. Arnold:

Yeah.

Mary Jo Henry:

In regards to COVID?

Dr. Arnold:

That, or just vaping in general. Just as kind of closure to what we talked about earlier in the winter I guess wasn't summer.

Mary Jo Henry:

That, again, we don't have big studies with conclusions yet, but, it looks like we know that there are a lot of the same harmful chemicals in the, what people are expelling when they're using the vaping products the same, a lot of the same harmful products that are in the cigarette smoke. We think that, they could be, predisposing people to the emphysema and cancer and heart disease and all of the other diseases that we know smoking contributes to. And then there's the nicotine addiction, which is kind of the root problem with vaping and cigarette smoking.

Dr. Arnold:

Yeah. I think we've, you know, we've talked extensively that vaping is not an alternative to smoking. It's not an safe alternative.

Mary Jo Henry:

Correct.

Dr. Arnold:

Rephrase that. But I think we could extrapolate, particularly for young people that vaping could predispose them to a more severe case of COVID-19 infection if they should contract that. And I think that's a safe assumption. Don't you think?

Mary Jo Henry:

I think so, yeah, and, and you know, we're seeing now too in New York and some of the other higher concentration of the COVID that there's a good percentage that are in the younger category and we don't know, yet, are some of them vaping and did that make them more disposed to that? I often wonder, too, if, you know, if they were not doing as much social distancing.

Dr. Arnold:

With the yeah, yeah.

Mary Jo Henry:

The younger population that contributed.

Dr. Arnold:

Yeah. We all saw the news clips of spring break and Daytona and a lack of social distancing. But you know, when I was 17, 18, I didn't worry about influenza or other concerns, but it is. And as I've said with the social distancing and the, self quarantine orders, you know, how many grandparents have to die before you're going to take this seriously?

Mary Jo Henry:

Right.

Dr. Arnold:

And I, I think that's one thing, Mary Jo, that people miss out on. I know you understand this, but just to explain it, we don't have immunity to it because nobody's had this before. It's new, novel, and we don't want our healthcare system to be overloaded with everybody getting sick at once. And that's the goal. I tell people all the time, this is not a numbers issue. It's a time issue.

Mary Jo Henry:

Right.

Dr. Arnold:

If everybody, you know, got sick like a flu season spread out over 12 to 14 weeks, no problem. But if everybody gets sick over a weekend or a week, 14 day period, it would put a significant strain on healthcare resources because we're just not prepared for that. I mean, why would we? I mean otherwise we'd have people standing around, you know, every for 15 years at a time and,

Mary Jo Henry:

Right.

Dr. Arnold:

Yeah. I get a little defensive when they criticize the fact we don't have testing, well, they just discovered this virus in December and the fact that we even have testing this fast is actually pretty impressive to have the genome mapped out. So what advice do you have people that are self isolating, they're at home, they're out of their routines? I mean, that's a, that's a temptation to either take up smoking or smoke more than they may have in the past. What advice would you give people that are in quarantine?

Mary Jo Henry:

Definitely not restarting. If you, if you haven't, that's not gonna make anything better. And, and most people who have quit smoking, it was a tough thing to get through and do it. And then to, if you start again, you have to go through that again at some point. Or, continue to have health consequences from continuing to smoke. And the other thing about smoking more, yeah, people tend to, when they're anxious and bored, are two the common things that people, reasons people smoke. And so trying to take good care of yourself and find other things to do, rather than smoking more and just, you know, taking care of yourself, exercising, that not only takes away from time smoking, it stimulates dopamine, which is a chemical in our brain that makes us feel good. And nicotine also does that. Stimulates that dopamine and that's part of that nicotine addiction. So if you can get that feel good feeling from exercising, it's a much better option than getting it from smoking. And then just, also, we know that exercise, being outside, makes anxiety better. It's a good coping skill for that. And then, you know, worst case scenario if you do end up getting the COVID knowing that you are not a smoker, or that you've been really working on trying not to smoke more, gives you a little peace of mind and a little bit of control over that situation.

Dr. Arnold:

That's good advice.

Mary Jo Henry:

Yeah.

Dr. Arnold:

Yeah. There's nothing, no one's saying if you're at home during this time that you need to stay inside.

Mary Jo Henry:

You can go outside, exercise, go for a walk.

Dr. Arnold:

Absolutely. Gyms are closed, of course, you know, because of the social distancing. But going for a jog, unless you're running really close to someone, you should be fine.

Mary Jo Henry:

Right. And you run into your neighbors, and, you know, we just do the walking the dogs. You run into neighbors you want to visit, you can still do that, you just stay six feet away from each other, and, you know, and that's also staying in if you are sick. But if you're not sick, you know, those are safe things to do.

Dr. Arnold:

Yeah. The World War II generation had to storm the beaches of Normandy to save the country and we just have to stay at home and watch Netflix, and, you know, we really shouldn't mess it up.

Mary Jo Henry:

Right. Absolutely. Absolutely not. And, you know, we don't know what timeframe yet, and I know a lot of people have made a lot of sacrifices and it is nerve wracking if you lost your job or you don't know when you're gonna be able to work again, but we will get through it. But the best way to do that is to listen to the people who, the medical experts and epidemiologic experts that know the best way to handle this.

Dr. Arnold:

I know you're over in the clinic, I don't know if you can give us a lot information on a timeline, but where is the clinic at with telehealth visits so people can, I know they've started some telephone visits.

Mary Jo Henry:

Telephone visits, yes, we're doing those.

Dr. Arnold:

Saw some of those documents. Yeah. But, telehealth, is that...

Mary Jo Henry:

We haven't gotten it yet. We're told that it's on the way, it's in the works, but we haven't, as of yesterday, we didn't have any information that was coming, but that will be helpful. And I saw, and, you know, the national and local news, you know, that there is concerns that people are not going to their regular appointments for their chronic disease and we need to find that balance because it's so important. We know that managing chronic disease with regular visits so we can make sure that they're doing, you know, taking their medicines that the medicines are doing what they're supposed to do. We're doing everything that we can to limit the progression of the disease and complications of the disease, are important. And we want people to feel safe and be able to do that. And, whether that's coming into the clinic, or doing telehealth visits, we'll be working on what's the best way to do that.

Dr. Arnold:

That is, that is great advice and a good update. And, perhaps, life-changing events such as a pandemic are a good opportunity to quit smoking.

Mary Jo Henry:

Absolutely.

Dr. Arnold:

Or to start exercising.

Mary Jo Henry:

Absolutely.

Dr. Arnold:

Those life changing events, those JFK moments sort of thing. Mary Jo, that's really great information. Thanks so much for taking the time to talk about this. Again, that was Mary Joe Henry, Tobacco Treatment Specialist at UnityPoint Clinic Multispecialty. If you have a topic you'd like to suggest for a Talk On... podcast, shoot us an email at stlukescr@unitypoint.org. We encourage you to tell your family, friends, neighbors, strangers about our podcast. Until next time, be well.