We’re all smokers now. And quitting might not be an option.

Alarmist? Not according to Dr. Michael Roizen, chief wellness officer emeritus for the Cleveland Clinic and a nationally known expert on health and longevity.

“If you’re not wearing an N95 mask, you’re smoking today,” Roizen said on Wednesday, June 28, as he walked indoors in filtered air from a treadmill in front of his standup desk, as he has done every day for many years.

The extremely bad air Northeast Ohio is experiencing is currently among the worst air pollution in the world — and the worst our region has seen in at least decades.

It’s no small matter when it comes to health, Roizen said. Even short-term (we hope) events like what we’re experiencing now have shown signs of having dramatic impacts.

“I don’t know what this sudden increase (in air pollution) will do here,” Roizen said. “But in Chinese cities when they’ve had these bad days, they’ve literally had a 50% increase in heart attacks … and those have lasted for three days after the (pollution) event ended.”

The problem is twofold, Roizen said, due to the very small particles contained in wood smoke, known as PM2.5 particles because they are only about 2.5 microns in size, and larger PM10 particles that still get into the upper lungs.

For the smaller PM2.5 particles, federal health experts recommend installing a MERV 13 furnace filter.

PM2.5, in particular, is a problem because particles that size not only work their way deep into the lungs, but they enter the bloodstream. There, they cause inflammation and can result in plaque breaking free from the walls of arteries and causing heart attacks.

That’s a problem, Roizen said, for those with underlying conditions like atherosclerosis and for nearly everyone over 50, who have nearly all accumulated arterial plaque.

“If you’re a heart patient, you should have a HEPA filter at your home and you wear an N95 mask if you’re outside,” Roizen said. “And pretty much everyone over the age of 50 has plaque … so this is a health issue for everyone over the age of 50.”

This is far from normal air for our region, even on a bad day, say air-quality experts in Cleveland and Akron.

“Lord, what a mess out there,” said Sam Rubens, who has been watching local air quality for 28 years as a lab analyst with the Akron Regional Air Quality Management District.

“It literally stinks here,” he said, adding that he was seeing the worst air quality index readings of his career Wednesday morning, when Akron and Cleveland were both experiencing what the federal government terms “very unhealthy” readings of about 270. And they were still rising at around 9:45 a.m.

“Normally, what happens is the wind gets stronger during the day,” Rubens said.

That means more smoke is likely to start moving our way, he said. But he also hopes that things will improve overnight.

“Through about 10 or 11 tonight, the wind looks like it is going to continue to come from the west and northwest, which is going to be dragging more smoke our way,” Rubens said. “Once the winds change, around midnight … I’m hopeful when we wake up tomorrow morning, this will be a memory.”

For now, at least, but that won’t mean that Northeast Ohio or much of the rest of the nation is out of the burning woods for long — only until the wind shifts again.

“The real problem is the fire, and the fire is not going away,” Rubens said.

By “fire,” he means several hundred individual fires that have been burning in Canada for months and are expected to burn for weeks or months more, with some fires predicted to burn through the winter due to their size and intensity.

Canada has been experiencing more wildfires in recent years due to climate change, scientists say, as have other regions of the planet near the poles, such as Siberia.

On top of that, the winds have been less predictable, Rubens said.

“Our prevailing wind is basically along I-71; it’s usually southwest to northeast. That’s a 30-year average, though, and it’s changed in the last 30 years,” he said.

The jet stream, in particular, has acted in peculiar ways, he said, bringing down air from Canada instead of moving it in the other direction as it’s normally done consistently. In the winter, that can manifest as a polar vortex, but in the summer, it can bring down smoke from Canadian wildfires. The more often that happens, and the larger and more numerous the fires are, the more smoke we will get.

“It all depends on whether Canada is on fire or not,” Rubens said. “And then it all depends on weather and the situation.”

This is a frustrating tragedy, say people including Rubens, Roizen and David Hearne, commissioner for the Cleveland Division of Air Quality, because it’s threatening to blunt the positive effects that decades of cleaning up the air in the U.S. and Northeast Ohio have brought.

“In general, our air quality is vastly improved,” Hearne said of improvements made in recent decades.

Roizen said people in the U.S. saw significant increases in their lifespans due to better air quality.

“The estimates are that just a change in air pollution in the United States from 1980 until the year 2000 resulted in an increased life expectancy of about 2.2 years,” Roizen said. “Then there was another gain of 1.1 years between 2000 and 2007.”

But the U.S. cleaned up its air during those periods by addressing pollution sources such as industry and transportation.

This new challenge is more difficult, though, and what lies ahead is more difficult to predict and plan for.

“The butterfly effect is real, and it makes it a big challenge quite frankly to look at and plan for things,” Hearne said. “When we’re facing wildfire issues, from anywhere … it just makes it very, very challenging. The health effects don’t care whether something is being produced by local transportation sources or international wildfire smoke. If you or your kid with asthma can’t breathe, you really don’t care what the source is.”

Ultimately, if we can do anything to address the problem, it likely will entail working closely with Canada to control fires there.

“It’s like mold in a home,” Rubens said. “If a pipe breaks and is spraying water on a wall, you don’t fix the wall, you fix the pipe. We need to address the causes of these fires.”

But that won’t be easily or quickly done.

So, for now, experts are telling people to avoid the smoke when it comes and prepare for future events with good furnace filters or even indoor air purifiers and “clean rooms” in a home that are sealed off from dirty air during very bad days.

“I’m going to minimize my outdoor time. Because it stinks and it’s hard to breathe. Thankfully, I don’t have underlying health problems,” Rubens said. “But I’ve already contacted the manager of our health department who works with seniors to push a message out to her constituency. This isn’t just a normal air quality advisory day.”