COVID-19 (Novel Coronavirus Disease) and SMOKING

COVID-19, the disease caused by the novel coronavirus, began in March 2020 and has undoubtedly changed the world permanently. First alleged to have evolved from a bat, a snake or the anteater mammal called a pangolin and passed to humans in Wuhan, China, in late 2019, this novel virus spread, and continues to spread, from person to person at a frightening pace in every part of the world. The victims of this pandemic include people in the world's poorest regions as well as Prince Charles of the British royal family, who leads a highly sheltered life. Compared with known forms of flu (influenza), the most distinctive leading symptoms are a dry cough and high fever. Given the highly contagious nature of this virus, which spreads particularly through hand contact and respiratory droplets, many aspects of social life have been put on hold worldwide, including going to work or school, leaving home and being in crowded places unless necessary. This includes social smoking. People who smoke products such as tobacco and cannabis (legal or medicinal versions are produced in some countries) generally do so in a social setting, sometimes even sharing a cigarette. This creates a highly favorable environment for the spread of many bacteria and other viruses as well as coronavirus. Consequently, people who smoke cigarettes or cannabis, use electronic cigarettes, hookahs and similar products are at increased risk of belonging to the group more severely affected by coronavirus, because of direct irritation of the lungs (the virus's main target organ) and upper respiratory tract, and possible weakening of their immune systems.

As is well known, smoking causes chronic obstructive pulmonary disease (COPD), cardiovascular disease and other respiratory conditions. People with these conditions have been observed to have a particularly poor disease course following COVID-19 infection. JAMA published case studies reporting a COVID-19 mortality rate of 6.3% among people with chronic respiratory conditions, compared with 2.3 among other people. In China, 52.9% of men smoke, compared with 2.4% of women, and this is thought to be one possible reason why COVID-19 is more fatal in men. According to the Chinese Center for Disease Control and Prevention, COVID-19 has caused more deaths among men than women. More research is needed to clarify how smoking increases risk in COVID-19 infections.

Electronic cigarettes have a serious adverse effect on lung health (see our e-cigarette dossier). Aerosols released by electronic cigarettes damage lung cells and reduce their response to infections. For this reason, people who use electronic cigarettes are also at risk from COVID-19 infection.

Opioid narcotic painkillers (such as morphine) affect the brainstem and slow breathing. Opioid use endangers the user's life and causes blood oxygen levels to fall. A lack of oxygen damages the brain and lungs. Chronic respiratory disorders are known to increase the risk of death from overdose among people who use opioids. These people, whose lung function is impaired, are also vulnerable to COVID-19 infection.

Another synthetic drug with stimulant and hallucinogenic properties is methamphetamine, whose use also increases the risk of COVID-19. Methamphetamine constricts blood vessels, causing lung damage and hypertension. Similarly, people who use this substance are at high risk of COVID-19 infection.

It is important to emphasize that smoking, electronic cigarettes and addictive substances that seriously affect lung function increase the risk of COVID-19 infection.

We think this period of staying at home is an excellent opportunity for quitting smoking. However, although quitting is difficult for habitual smokers, precautions that can be taken individually include:

• Stock up for at least 1 month and limit how often you go shopping.
• Masks are necessary for patients and healthcare workers; if you have no symptoms, maintaining personal hygiene will be sufficient.
• When you wash your hands with soap, the chemical structure of soap means that you not only wash the virus away but also destroy it.
• Stop sharing cigarettes; this invites the spread of coronavirus and many other viruses.
• Practice social distancing and stay at home. Work from home if you can, and limit leaving the house as much as possible.
• Plan your shopping carefully, arranging it weekly if possible, and maintain a distance of 2 meters from others.
• If your own health puts you at low risk, help people at high risk with their shopping needs.
• Online rumors claiming that cannabis oil or cannabis protects against the coronavirus outbreak are not based on any scientific research. Please do not give them credence.
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