Smoking (these data are preliminary)
13 studies covering 5,960 hospitalized COVID-19 patients: 6.5% recorded as smokers (average)
Peer-reviewed study of 50 hospitalized COVID-19 patients: 6% recorded as current smokers
We are still in the early days of the COVID-19 pandemic, and many questions remain. What is the relationship between smoking and risk of infection, hospitalization, or severe complications? Do smokers who switch to vaping nicotine face similar risks? And, finally, is the media reporting on these issues accurately?
The only certain answer to the first two questions is that it’s too early to say. We need more data. Ideally, a careful nicotine use history would be recorded for all patients with COVID-19 admitted to hospitals. Where feasible, these patients would be tested for nicotine use and for the products of combustion from cigarettes and bidis to verify self-reported histories.
As scientists love to say, “More research is needed.” There are knowns, known unknowns, and probably a lot of unknown unknowns. Current evidence on the relationship between COVID-19, smoking and nicotine vaping ranges from strong to none.
Long-term smokers are more likely to suffer from colds, influenza, and pneumonia than non-smokers. They are also more likely to develop ‘comorbidities’ like chronic obstructive pulmonary disease (COPD). However, at least in the United States, ‘only’ 13–15% of current smokers suffer from COPD. These individuals are more likely to suffer severe COVID-19 complications.
Based on the above table, there is currently no evidence that smokers who are diagnosed with COVID-19 are more likely to be hospitalized than non-smokers. But disease severity may differ. For example, one study of 1,099 COVID-19 patients in China found that 21% of smokers, and only 14% of non-smokers, developed complications. Unfortunately, there is no evidence yet on any potential links between COVID-19 and vaping. There is, however, intriguing evidence that most smokers who switch to nicotine vaping have fewer respiratory tract infections (colds and flus), coughs, and phlegm.
So far, there is no credible evidence that smokers or nicotine vapers are more likely to be infected with coronavirus. Nor is there evidence linking vaping to COVID-19 hospitalization or complications. Logically, there are three possibilities for nicotine vapers — vaping may increase, decrease, or have no effect on COVID-19 risk. All three possibilities should be studied during this pandemic.
Is the media reporting this accurately?
Here is a small, representative snapshot of relevant global news between April 8 and April 13, 2020:
The relationship between smoking and COVID-19 is complex, possibly counterintuitive, and rarely reported accurately in the press. With or without COVID-19, we must never forget that there is overwhelming evidence linking smoking to 7 million deaths every year from cancer, heart, and lung disease. There is an urgent need to develop and ensure access to safer and more effective smoking-cessation products and services.
* Average smoking rates for adults (male and female) in each country. In France, Germany, and the United States, gender differences in adult smoking are modest. Note, however, that in China at least 44.8% of men smoke, but only 2% of women.
Mission is to eliminate smoking worldwide by supporting cessation & harm reduction #research, and transitioning tobacco #farmers to alternative livelihoods.
Nearly half of all tobacco users are concentrated in China, India & Indonesia. What is preventing the implementation of effective #cessation and harm reduction strategies to help people quit smoking in these three countries? Learn more:https://bit.ly/3mWNhQp #fightagainstsmoking
.@CDP_innovation recently released a whitepaper on impediments to tobacco harm reduction in low-to middle-income countries where 80% of the world’s tobacco users live. Read the paper here: https://bit.ly/3t4idlo
Renée O'Leary and @RiccardoPolosa describe the potential benefits of #tobaccoharmreduction, as well as barriers to its adoption. Cultural leeriness of #HRPs, they note, often stems from misperceptions about these products. https://bit.ly/3evl8Zf
The Tobacco Transformation Index measures the extent to which companies are making material progress toward reducing the consumption of high-risk products and contributing to tobacco harm reduction efforts. More on @Swedish_Match’s divestment here: https://bit.ly/3zPJUzF
.@CDP_innovation released a whitepaper on the impediments to #THR in low-to middle-income countries. In #China, 83% of tobacco smokers were aware of “e-cigarettes” or “vapes”, but only 27% in #Indonesia & 12% in #India were aware. Read the paper here: https://bit.ly/3t4idlo
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