Journal of Pulmonary Medicine

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Vulnerability of users of Tobacco/ Nicotine in any form including E-cigarettes to COVID 19

Now it is well documented that, smoking of tobacco or E-Cigarette would increase chances of COVID-19 infection and progression of this deadly disease. Smoking affects and reduces general immunity of the body and reduces cell-mediated immunity. Smoking also reduces the mobility of cilia (small fibres on the surface of the lungs) that clean, defend and protect the lungs. It is clear that the COVID-19 as well as smoking, directly and seriously affect lung health. In the largest study from China, there were 1099 patients; 173 severe; and 926 non-severe. The data shows that among the severely affected patients, 16.9% were current smokers while 11.8% were among non-severe. Among those reaching endpoint (defined as needing mechanical ventilation, admission to an ICU or death): 25.5% were current smokers and 7.6% were former smokers.There is also a misconception among the general public that water pipe or hookah smoking is less harmful than cigarette and E-Cigarette smoking, as these also affect the lung's health equally. There are at least 82 toxic chemicals and carcinogens in hookah smoke. The heating of charcoal used to heat tobacco in hookah poses health risks since the heating process produces harmful products such as carbon monoxide, metals, and other chemicals. A meta-analysis of 12 published papers, with a total of 9,025 COVID-19 patients was done to determine the association between smoking and progression of COVID-19. It was concluded that smokers were having higher odds of COVID-19 progression than never smokers. It is also a misconception that e-cigarettes are a safer alternative as in 2019, many people lost lives due to “E-cigarettes use or vaping product use associated lung injury (EVALI)

We need to be cautious about the unproven claims in media that tobacco or nicotine could reduce the risk of COVID-19. As per WHO, there is currently an insufficient information to confirm any link between tobacco or nicotine in the prevention or treatment of COVID-19.

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