What Is the Relationship Between Smoking and Coronavirus (Covid-19)?

As the world marked World No Tobacco Day on May 31, many took it upon themselves to think about the impact of tobacco usage on COVID-19 outcomes. The Coronavirus has infected more than 7 million people in 198 countries and territories, with a mortality rate of more than 350,000.

The usage of tobacco is linked to diseases of almost all organs in the human body. Researches in various countries have shown that middle-aged smokers tend to have 2-3 times the death rate of non-smokers in the same age group, decreasing lifespan by almost an average of 10 years. Tobacco consumption through smoking and e-cigarette increases the risk of pulmonary infections as it damages the upper airways causing lung inflammation, and degraded lung immune function.

There should be no surprise, then, that preliminary evidence suggests that smoking is a risk factor for Coronavirus, with tobacco smokers having more than 1.91 times the likelihood of progression in Coronavirus severity in comparison to non-smokers. This discovery is reinforced by another research showing that Coronavirus infection was linked with significantly higher mortality and severity rates in people with COPD (chronic obstructive pulmonary disease) and among tobacco users.

Data collected from China gives insights into the epidemiology, clinical, and biological, characteristics of Coronavirus. The sex distribution among affected patients shows that the male population forms the majority of the cases. Researchers from China reported that up to 58.1% of patients from across 30 provinces were predominantly male. Also, amongst the first 425 cases reported in Wuhan, 56% were also predominantly male. Additionally, an article written in the Journal of American Medical Association indicated that death rates amongst infected men, particularly those in the late 40s or older, have surpassed those of women.

In earlier outbreaks of the Coronaviruses, such as MERS and SARS, men were also predominantly affected. During 2003 in Hong Kong, for example, researchers found out that men infected with SARS had almost a 50% greater risk of death in comparison to women.

Why the discrepancy?

A greater smoking preference among men often results in a weakened lung function, this may assist in explaining their higher Coronavirus fatality rate.

Tobacco usage also accelerates the onset of co-occurring illnesses like lung cancer, cardiovascular diseases, diabetes, and, COPD. These conditions are more prevalent among the male population and also heighten the risk of Coronavirus severity and death.

As described in the U.S. Surgeon General’s Report of 2004:

“Toxins from tobacco smoke harm the human body from the second they enter through the nose and mouth. They damage cells and tissues all through to the lungs. When a cigarette is smoked or inhaled, chemicals found in tobacco are absorbed in the lungs. Consequently, smoking causes respiratory diseases and makes chronic respiratory diseases more severe. Although the lungs have ways to protect themselves from injury caused by inhaled agents, smoking overwhelms these defences. Prolonged smoking causes lung tissue to become scarred, losing its elasticity, hence no longer able to exchange air efficiently.”

What to do?

Apart from monitoring tobacco use, governments also have a responsibility to address tobacco use in their policies to mitigate and contain the impact of Coronavirus. The most effective strategy for tobacco control is through taxation, so administrations must act swiftly to increase taxes on e-cigarettes and cigarettes. This strategy has been proven to reduce and prevent the use of tobacco, particularly, and hence improving health in addition to reducing the risk of premature death. Taxation can also assist in expanding the tax base and raising additional funds for economic recovery after the pandemic subsides.