People who smoke and those who are exposed to secondhand smoke suffer more frequently and more severely from respiratory infections because tobacco smoke impairs several components of the respiratory defense mechanisms; therefore, they are at greater risk not only of contracting COVID-19 but also of having a worse prognosis if they become infected.
In the outbreak of MERS-Cov “Middle East Respiratory Coronavirus Syndrome” that occurred in 2012, tobacco use was identified as an independent factor for infection, but recent studies suggest that smokers have a higher risk of being infected by SARS-Cov-2, which is the cause of COVID-19, and in addition to suffering from this disease with greater severity, it is fully demonstrated that this infection is more severe in smokers than in non-smokers.
In addition, the use of electronic systems (known as electronic cigarettes, e-cigs or vapers), heated tobacco products and passive exposure to tobacco smoke expose users to particles and toxicants that generate interactions in the respiratory defense mechanism similar to those produced by combustible tobacco.
Therefore, it can be determined that tobacco consumption is not only associated not only with a worse evolution of this disease but also with a higher risk of contagion.
Exhaling the smoke or aerosol released by electronic cigarettes increases the number of Flugge droplets, and at the same time increases the chances of transmission of the coronavirus, since the viral load expelled by a smoker who is infected when smoking or vaping is higher than that which can be expelled by a non-smoker who is infected.
The recent survey conducted by the Ministry of Health, National Committee for the Prevention of Smoking, found that 81.52% of respondents were aware of the increased risk of tobacco use with the aggravation of COVID-19 symptoms.
Smoking or vaping increases the possibility of transmission of the virus through the mouth to the extent that it involves repeatedly bringing the fingers to the mouth statistically this increase is more than 300 times of the mocha hand mouth movement of the non-smoking subject.
Quitting tobacco use has an almost immediate positive impact on the smoker’s pulmonary and cardiovascular function, according to the World Health Organization (WHO). Therefore, while quitting smoking is always the wisest decision a smoker can make, quitting now is especially relevant to prevent contact with BOC 19 and, if necessary, to reduce its complications.
Water pipes and vaping techniques are also particularly serious, even if disposable mouthpieces are used, since these practices triple the risk of contagion not only because of the improper use of mouthpieces but also because of the repeated hand-to-mouth maneuvers and the difficulty of maintaining physical distances between people who use them.
All public and private environments should be kept 100% free of tobacco smoke, especially in the pandemic situation we are experiencing, since it is necessary to strictly comply with the current legislation regarding tobacco consumption in enclosed and open public spaces, since all of them can be considered as critical points of contagion.
Finally, it is important to take into consideration that airborne transmission may be the dominant route for the spread of COVID-19, and that according to a study conducted by the University of Texas, transmission of the virus can occur via three routes:
- Direct contact with people occurs over short distances.
- Indirect contact deposited on objects.
- By air in reference to droplets and aerosols, thus large droplets contaminate people and objects; aerosols are efficiently dispersed in the air and can transmit the virus over a longer distance and time.