Caring for Someone with a Smoking-Related Illness

If you're a CDPAP caregiver for someone with a smoking-related illness, here are some things you should know about the kinds of symptoms and diseases you can expect and ways to help your client.

Whether you're an informal caregiver or you're working within New York's Consumer Directed Personal Assistance Program (CDPAP) for Medicaid recipients, it's crucial to know some of the background on smoking-related illnesses.

Smoking statistics

Cigarette smoking is the leading cause of preventable death in the United States. According to the Centers for Disease Control and Prevention (CDC), smoking-related diseases kill more than 480,000 Americans every year. It’s directly responsible for nearly 90% of lung cancer and COPD deaths, but can cause many more illnesses and health complications.

More than 16 million Americans currently live with a disease caused by smoking. That means for every person who dies because of smoking, around 30 people live with serious smoking-related illnesses. Smokers die approximately 10 years earlier than non-smokers. Secondhand smoke also contributes to approximately 41,000 deaths each year.

Smoking costs the U.S. economy over $300 billion a year, with more than $225 billion of that going towards medical care for adults. The U.S. loses over $156 billion in productivity due to premature death and exposure to secondhand smoke as well.

What diseases are smokers at risk for?

Smoking can harm nearly every organ in the human body. It most commonly causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis. Smoking also increases a person's risk for tuberculosis, some eye diseases, and immune system dysfunction, such as rheumatoid arthritis.

Here is the breakdown of diseases that occur more often among those who smoke(d):

Heart disease and stroke

Smoking can cause heart disease and stroke in a few different ways. First, it can raise triglyceride levels in your blood, lower your "good" cholesterol, and block blood flow to the heart and brain by making the blood more likely to clot. It also damages the cells that line your blood vessels and can cause thickening and narrowing of the blood vessels. 

A person is 2-4 times more likely to suffer from a cardiovascular disease if they smoke(d). Even non-smokers who breathe secondhand smoke increase their risk of developing heart disease by 25–30% and their risk for stroke by 20−30%.

Lung cancer

Substances in tobacco can damage a cell's growth and function and weaken the body's immune system. When a person inhales cigarette smoke, chemicals enter the lungs and spread throughout the body. If a cell's DNA is damaged by these poisons, it can cause uncontrolled cell growth, forming tumors. 

Nine out of 10 lung cancers are caused by smoking. The likelihood of getting lung cancer increases by 25 times for male smokers and 25.7 times for female smokers. Over 7,300 non-smokers die each year from lung cancer caused by secondhand smoke.

According to the CDC, the risk of lung cancer from smoking has gone up since the 1960s because of the way cigarettes are made today.

Blood vessel diseases

Smoking damages blood vessels, causing them to thicken and narrow. When this happens, blood pressure goes up, and clots can form in veins and arteries.

In addition to causing heart attacks and strokes, damaged blood vessels can lead to hypertension, aneurysms, and circulatory problems such as peripheral artery disease. 

COPD

Chronic obstructive pulmonary disease (COPD) is a group of diseases including emphysema and chronic bronchitis. Smoking causes these breathing-related problems by damaging the airways, making them more likely to be chronically inflamed or leading to mucus buildup that restricts airflow to the lungs.

Smokers are 12 to 13 times more likely to die from COPD than nonsmokers. Currently, there are nearly 16 million U.S. adults with COPD, and 38% report that they still smoke. Teenage smokers can impede the growth and development of their lungs early on, making COPD more likely in adulthood.

Asthma

Tobacco smoke is a powerful trigger for asthma. When inhaled, it irritates the lining of the airways, damages the cilia (which help sweep away other irritants), and causes the lungs to make more mucus. 

Even children in utero are more likely to develop asthma if their mothers smoke while pregnant.

Cancers

Smoking can cause cancer as well as affect your body’s ability to fight it. But the damage is not limited to a person’s lungs. The damage can occur just about anywhere in the body, including the blood, bladder, cervix, colon, esophagus, kidney, larynx, liver, mouth and throat, pancreas, and stomach.

Quitting smoking can reduce your risk for up to 12 types of cancer.

Oral (teeth and gum) diseases

Smoking is one of the causes of gum (periodontal) disease, an infection of the gums that affects the bone structure supporting your teeth. If the condition is severe, it can make your teeth fall out.

Smoking damages gums by making it more likely for the bacteria that get on our teeth during the day to get under the gums and form layers of buildup. Being a smoker makes it harder for gums to heal after any damage.

Type 2 diabetes

There are at least 2 ways smoking can cause Type 2 (or adult-onset) diabetes. Cigarette smoke injures the body's cells and causes them to swell and stop functioning correctly. It also causes oxidative stress when chemicals from tobacco combine with oxygen in the body. Both of these lead to inflammation, which increases a person's risk of diabetes.

In addition, smoking is associated with a higher risk of belly fat. People with increased belly fat have higher cortisol levels, which increases blood sugar and causes diabetes.

People who smoke cigarettes are 30%–40% more likely to develop type 2 diabetes.

Cataracts

Smoking is linked to cataracts, which causes blurry vision and can lead to vision loss. This may be because it increases the number of free radicals in the eyes, which leads to damage of the lipids and proteins.

Smokers are 2-3 times more likely to develop cataracts than non-smokers.

Rheumatoid arthritis

While the link is not well-understood, smokers have a higher risk of severe rheumatoid arthritis. They are also less likely to go into remission or get relief from the drugs used to treat the disease.

Female-specific smoking outcomes can include:

Preterm delivery

Women who smoke are more likely to give birth prematurely. This can increase a baby’s risk for developmental delays, breathing problems, and more.

Stillbirth

Smoking can lead to problems with a placenta or slow fetal development, causing a miscarriage or stillbirth.

Low birth weight

Smoking can cause babies to be born with a low birth weight. This leads to health problems and disabilities, including developmental delays, cerebral palsy, and hearing or vision ailments.

SIDS

Women who smoke or are around secondhand smoke during pregnancy increase their infant's risk of sudden infant death syndrome (SIDS), the leading cause of death in healthy infants.

Ectopic pregnancy

The nicotine in cigarettes can cause contractions in the fallopian tubes and prevent an embryo from passing through. This can lead to an ectopic pregnancy in which a fertilized egg implants outside of the uterus, possibly causing life-threatening complications for women.

Orofacial clefts in infants

Only recently have researchers found a statistically significant link between mothers who smoke and infant cleft lip and palate. In addition, smoking leads to larger palate defects.

Low bone density

Research has shown a direct link between smoking and low bone density in women over 40. This heightens a woman’s risk of osteoporosis and serious fractures later in life.

Caring for someone with a smoking related illness

If you are caring for someone who has a smoking-related illness, it's crucial to get an individualized treatment plan from their doctor. Each disease will require a different approach.

Regardless of what smoking-related disease a friend or loved one is suffering from, the primary goal will be to get them to quit smoking if they haven't already. Smoking will only continue to make conditions worse and treatments less effective. It will also potentially expose you to their secondhand smoke.

It's also crucial to talk to anyone else living in the house about smoking around a person with a smoking-related disease. Of course, even when people want to give up smoking, the addictive characteristics of tobacco make it difficult.

If necessary, you can help the smoker take small steps towards quitting, such as cutting down on the number of tobacco products they use per day. If they are life-long smokers, this may take months, and people aren't always successful on their first attempt.

Caregivers will need to be patient with anyone addicted to tobacco. In some cases, rehab will be a necessary intervention to break the cycle of addiction and improve their health. But you can also talk to the person's doctor about prescription or over-the-counter options for smoking cessation. 

Benefits of quitting smoking

If someone is already sick, it may be harder to get them to quit smoking if it's something they enjoy or feel their body needs. Quitting is difficult and can make people feel worse temporarily as they overcome their addiction.

However, speaking with your loved one about the benefits of quitting tobacco may help. These include:

-          A decreased risk of cancer, heart disease, and other ailments

-          Reduced cough

-          Improved sense of smell or taste

-          A reduction in asthma symptoms

-          An increased chance that disease treatments will be successful

-          Saving money by not buying cigarettes

Caregivers have their work cut out for them when it comes to caring for people with smoking-related diseases. But their quality of life can be significantly improved by obtaining tobacco.