EDMONTON - The raw, red burn scars on Al Pombert's face are a warning of what can happen to someone who smokes while on oxygen therapy.
Pombert said he didn't think twice last November about lighting up, even though he was on oxygen for treatment of chronic obstructive pulmonary disease and emphysema.
The resulting explosive fire could have killed him.
"I was actually crying. That is how much pain I was in," Pombert, 70, recalled Tuesday. "For two or three days I was in excruciating pain."
Pombert said the pain was even worse during healing when nurses had to shave scabs of burned flesh from his face.
Health officials say a growing number of people, mainly seniors, are suffering serious burns from smoking while on long-term home oxygen therapy.
Dr. Edward Tredget, a burn treatment expert at the University of Alberta Hospital, said injuries can include blistered skin and burns to the face, airways, hands and body.
In some cases, people die from their burns or are so injured they require skin grafts and long stays in hospital.
Tredget said it's actually illegal for someone on oxygen therapy to smoke, but some do anyway because they are hooked on tobacco.
Family and caregivers are sometimes part of the problem.
"In some ways it is difficult to ask somebody who has smoked all of their life to stop suddenly," he said.
"Many of the patients who are living in nursing homes are having cigarettes provided for them by their loved ones and, in some cases, by members of the hospital where they are staying.
A study published in the United States last year estimated that more than one in five home oxygen therapy patients smoke. Alberta estimates that more than 35 people have been treated for such burns in the past 10 years. There were no national figures available.
Electronic cigarettes have also been cited in such fires. Health Canada said there was a case in Quebec in November 2014 involving a person using an e-cigarette. The agency said there have been similar cases in other countries.
"Health Canada is warning consumers of potential risks of using electronic cigarettes while undergoing oxygen therapy," the department notes on its website.
"Electronic cigarettes include heating elements and power source."
Tredget said some people just don't understand that oxygen in a bottle is not like breathing regular air. Bottled oxygen is pure and acts as an accelerant that makes a fire burn hotter.
Health officials hope that raising awareness and getting people to quit smoking will reduce the problem.
In New Zealand, people who are caught smoking while on oxygen therapy are banned from using the bottles, Tredget said.
He added that people who smoke while on oxygen also pose a threat, because a fire could hurt others and damage where they live.
Pombert, who had smoked since he was nine, said there is nothing like the pain of being burned to drive home the danger. He hopes people will learn from his mistake.
"I have not had one cigarette since. It has been cold turkey."