Why Are Smokers At Higher Risk of Severe COVID-19 Infection?

Mar 27, 2020
Medically reviewed by Dr. Maroof Ahmed, MD on 
Mar 27, 2020

As the world unites to confront the omnipresent threat of COVID-19, many of us find ourselves in the position of not knowing how best to protect ourselves from this invisible enemy. 

If you smoke or vape, experts are saying that you make yourself more vulnerable to a severe infection from the novel coronavirus.

A recent report from the World Health Organization (WHO) claims that smokers have an increased susceptibility to COVID-19 and are more at risk of developing serious lung disease. New York doctors have gone so far as to urge Governor Andrew Cuomo to issue an executive order that would ban the sale of all tobacco products.

There is an abundance of evidence illustrating that smoking triggers inflammation and suppresses immune function in the lungs. However, with the many emerging studies now indicating that smoking—and possibly vaping—may increase the risk of developing serious infections from the novel-coronavirus, we ask ourselves how does this affect us and what can we do to limit the reach of this disease?

How coronavirus affects smokers

Firstly, smokers are more likely to be vulnerable as the repetitive hand-to-face movements provide a direct route of entry for potential viral capsules to the lips and mouth.

COVID-19 is typically a disease of the respiratory system, with emerging evidence indicating that cellular entry, viral replication and shedding occurs within the respiratory tract. Smokers may also have existing lung disease or reduced lung capacity putting them further at risk.

A leading theory is that SARS-CoV-2 (Novel-coronavirus) enters cells using the ACE-2 receptor, which is abundant in the lungs. One study has already found higher ACE-2 levels in smokers compared to non-smokers, indicating that smokers may be more susceptible to COVID-19 and smoking history should be considered when identifying at-risk populations.

More worryingly, a recent systematic review of five COVID-19 studies has calculated that compared to non-smokers, smokers were 1.4 times more likely to have severe symptoms of COVID-19 and approximately 2.4 times more likely to be admitted to ICU, need ventilation or die. This suggests that with the limited data available, smoking is likely associated with the negative progression and adverse outcomes of COVID-19.

So if you are a smoker or know someone who smokes, is there anything you can do to protect yourself? 

How should smokers protect themselves?

Evidence already tells us that after two weeks of quitting smoking, our immune system becomes significantly stronger. Quitting also improves circulation, lowers blood pressure and heart rate, increases oxygen levels and leads to increased lung function; all bodily conditions associated with decreased susceptibility to COVID-19.

In addition to the benefits already associated with smoking cessation, it is also believed that an increase in quit rates could help reduce transmission of SARS-CoV-2. 

During viral pandemics, a combination approach involving both behavioral and pharmacological interventions (e.g. social distancing, travel restrictions, treatments and vaccinations) is best able to minimize the spread of the disease. 

Many health experts believe that high-intensity smoking cessation support should form part of public health efforts during respiratory disease pandemics such as COVID-19.

The CDC also reports that almost 7 out of 10 adult smokers want to quit, with over half of all of them making a quit attempt at least once in that year, but the large majority not succeeding.

Digital, remote-first programs like Quit Genius allow smokers to access gold-standard support without seeing a counselor in person. Quit Genius uses a combination of app-based Quit Coaching, wearable technology and medication to help people change the habits they associate with smoking leading to sustained behavior change.

Smokers now find themselves in the unique position of not only being able to improve their own life, but by preventing the transmission of the SARS-CoV-2, the potential to help countless others as well.

If you’re interested in the many benefits of quitting smoking and reducing your risk to COVID-19, feel free to get in touch! Remember, as your health is our priority, we have made the decision to offer employers access to our industry-leading program at no cost for members signing up in March and April 2020. 

Stay safe, quit now.

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