The Foundation for a Smoke-Free World commissioned a poll in five countries that explores the relationship between COVID-19 social distancing and health among 6,801 tobacco and nicotine users. More than two thirds of the respondents rely on tobacco and nicotine as their main tool to manage stress and anxiety. Nearly 40% of smokers increased use of these products in recent weeks, which could equate to elevated use by more than 50 million smokers in the five countries polled. The havoc wreaked by the COVID-19 pandemic is twofold: in addition to suffering direct effects of the virus, the world is grappling with the challenge of social distancing. The mental and physical toll of this practice may be particularly profound for millions of smokers who, as a way to cope with stress, have increased their tobacco intake. The “COVID-19 State of Smoking Poll” was conducted online by the Nielsen Company for the Foundation for a Smoke-Free World during the period starting April 4 and ending April 14, 2020. Survey respondents from the United Kingdom, Italy, South Africa, India, and the United States (New York and California) were between the ages of 18 and 69, and were regular smokers of combustible tobacco or users of nicotine vape products.