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New data on the link between tobacco smoking and severe COVID-19 manifestations

During the first few weeks of March 2020, Colin Finnerty, a 21-year-old lift operator at a popular ski resort in central Idaho came down with a cold. While he had heard about the COVID-19 pandemic spreading across the country, he also recalled many news stories about how it wasn’t affecting younger people his age and didn’t think twice about it. Three days later his condition had worsened significantly: an unshakeable fever, and vomiting for seven hours straight. A trip to the hospital revealed he had pneumonia in one lung, and he was tested for COVID-19 and sent home with some antibiotics. Two days later he would return to the hospital, receiving oxygen support and spending the next week coughing up blood, suffering from extreme dehydration, fevers, and body aches.

His positive COVID-19 test wouldn’t be confirmed until three days after he had been discharged. Sitting at home recovering, Colin wondered if his nicotine habit had nearly cost him his life. In an interview with KQED FM, Colin stated “I did vape, and I did smoke, and it did hit me super, super violently”.

What Colin didn’t know then, but what we know now, is that smoking and e-cigarette use are habits that place people in a higher risk bracket to not only to contract COVID-19 but to have a more adverse case of the disease. A recently published literature review, “Tobacco use as a well-recognized cause of severe COVID-19 manifestations, suggests that tobacco use/smoking is a potential risk factor for COVID-19 infections with severe presentation”. The review, published in Respiratory Medicine, combed through articles from January 1, 2020, to September 10, 2020, using keywords such as “tobacco,” “COVID-19,” and “smoking” to tease out relevant studies and articles showing evidence that tobacco use may be an indicator for severe COVID-19 manifestation. 23 studies were included in the analysis leading to the review’s conclusion that “there is a very close association between tobacco use and severe COVID-19 manifestations.”1

While the review continues to explain the methodology used in both the literature review and some of the studies included within, as well as the biological mechanisms behind the causes of this association, it ultimately concludes by addressing the heart of the issue: perhaps the COVID-19 pandemic may be a “game-changer” towards helping to achieve a tobacco-free world by showing real-time evidence of disease severity presenting in tobacco users versus those who do not use.

Furthermore, they explain that while the tobacco industry has “exploited” the pandemic using forums like social media to market tobacco products to youth, this halting of normal social situations and a slowdown of the movement of goods could and should be used by healthcare professionals and the greater tobacco cessation community as a catalyst to help push for more tobacco cessation programs now more than ever, using the evidence shown that tobacco use is associated with severe COVID-19 presentations as additional incentive to motivate quitting.

References: 1. Gupta, Alpana K., Suzanne Tanya Nethan, and Ravi Mehrotra. “Tobacco use as a well-recognized cause of severe COVID-19 manifestations.” Respiratory medicine (2020): 106233.

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