A June 18, 2020 PLoS One study found that among 620 lung transplant candidates, that 92 (15%) tested positive for cotinine, a nicotine marker and metabolite. Sadly, 78 of the 92 (85%) lied about not having consumed any nicotine-based products prior to the test.

Why lie, and why so many?

Imagine that decades of smoking had destroyed your lungs. You've been diagnosed with end-stage lung disease, with less than a year to live. Even with oxygen, you fight for every breath. Your only hope is a lung transplant. There’s just one problem. Although less, you still smoke.

As mentioned in the study, "Smoking in solid organ transplant recipients is associated with an increase in graft loss, cardiovascular events, malignancy, and mortality and is therefore regarded as an absolute contraindication for lung transplantation."

So, you lied to your doctor when asked about smoking. You felt you had to. You did some reading and discovered that it’s the only way to get on the lung transplant waiting list.

But lying only gets you so far.

The waiting list’s rules for both lung or heart transplants state that "While on the waiting list, unannounced nicotine screens by cotinine urine test will be performed at least every four to six weeks."

"If the patient has a positive cotinine urine test during the time he or she is awaiting transplant, the transplant center will either make the patient inactive on the waiting list or de-list the patient from the waiting list."

According to the PLoS One study, the median survival after lung transplantation is 6.7 years, which the study attributes primarily to allograft dysfunction and side effects of immunosuppression.

Besides smoking actually causing allograft dysfunction, smoking after lung transplantation further diminishes survival due to smoking-related cancers and vascular disease.

And if you are a long-term smoker whose driver’s license indicates a desire to become an organ donor, there are problems there too.

According to a 2015 study, "There was a significant decrease in survival for cystic fibrosis patients who received lungs from a donor with a history of smoking." "Nearly 60% of subjects who received lungs from a smoking donor died during the study."

One final study. A 2015 Czech study measured urinary cotinine in 163 patients prior to inclusion on the transplantation waiting list, and in 53 patients after bilateral lung transplantation. While only 5% tested positive for cotinine prior to transplant, 15% were positive after receiving two replacement lungs.

The Czech study reflects that you can only stay afraid of smoking's harms for so long before growing numb to them.

How many times have you heard, or blocked-out, the warning that smoking kills half of adult smokers?

Why wait until smoke toxins damage your lungs or heart beyond the point of saving them? Why wait until near-death forces you to seriously consider ending your slow suicide?

Sleep on this, that knowledge truly is power.

What do you have to lose by becoming vastly smarter and far wiser than your addiction is strong?

Just one nicotine dependency recovery lesson at a time, yes you can!

---

---