AS a practising pulmonologist, I am extremely concerned by the widespread false news that smoking can help protect against the coronavirus. In fact, the opposite is true as cigarettes leave the smoker and those around him or her more vulnerable to the disease.
Government guidelines on coronavirus precautions call on people to avoid touching their mouth, yet that is precisely what you do when you smoke. The act of smoking means that fingers, and possibly contaminated cigarettes or e-cigarette devices, come repeatedly into contact with our lips. This increases the possibility of the transmission of the virus from hand to mouth.
Moreover, the act of exhaling raises the risk of the virus spreading to those around you. This is particularly dangerous during the lockdown as contaminants from smoke can stay in enclosed rooms for hours putting at risk all those coming in and out of the area. The same danger applies to water pipes or sheesha as second-hand smoke and the possible sharing of mouthpieces and hoses could also facilitate the transmission of Covid-19. Importantly, patients who have tested positive for the coronavirus should also refrain from using nebulisers at home as steam pumped out by the machine can also facilitate the spread of the virus.
Smoking does not protect against the virus.
There has recently been widespread media coverage and circulation of WhatsApp messages summarising the findings of a small study from France that implied that the use of nicotine can help protect against the virus. The news led to nicotine patches selling out in France and just like other instances of hoarding, the rush on the stores was unwarranted. Firstly, nicotine is a very addictive substance and so the use of nicotine patches against Covid-19 is a dangerous option to pursue. It would be the equivalent of using strong, addictive painkillers to relieve a muscle injury even through precautions such as rest can be effective.
More importantly, the researchers clearly warn in their paper that smoking causes a number of incurable non-communicable diseases such as chronic obstructive pulmonary disease, or COPD, which damages the lungs. Since the coronavirus attacks the lungs, a Covid-positive patient who smokes is more likely to develop serious symptoms such as hypoxia (or oxygen deprivation) and pneumonia associated with the coronavirus. Even those who have recently quit smoking face a higher risk of contracting a wide range of respiratory viral and bacterial illnesses with those infected likely to experience worse outcomes. This is because any kind of smoking harms the respiratory immune defence by inflaming the airways and disrupting the clearance of mucus and other harmful substances.
While most people are aware of the need to keep a distance of six feet from one another, this guideline pertains to coughing and sneezing. Smokers and sheesha users are exhaling contaminants and fumes that can go much further than six feet. Breathing in this second-hand smoke will not only expose one to Covid-19 but can also worsen asthma in those around the individual. I saw one such case recently in my clinic where a teenager started to suffer bouts of asthma because of a parent smoking sheesha at home.
There are immediate health benefits to quitting the smoking habit, and doing so would leave one better able to manage any pre-existing conditions if infected with the coronavirus. These benefits grow with time and may also increase the ability of Covid-19 patients to respond to the infection and potentially reduce the risk of developing severe symptoms.
I am often surprised to see people on the street wearing face masks that they lower in order to smoke. While they are taking precautions against the virus, they are engaging in a much more dangerous activity that claims some eight million lives a year, according to the World Health Organisation. It makes no sense at all to protect oneself against a virus while exposing oneself to toxic chemicals that can cause a number of cancers as well respiratory and cardiovascular diseases. Smoking is also a risk factor for both hypertension and diabetes, two diseases that are associated with the worse outcomes for Covid-19.
As the world prepares to observe No Tobacco Day at the end of May, we should have no doubts as to the public health hazards associated with smoking. Ramazan represents a period of abstinence and I know of many stories of people who have successfully quit the habit during this month. Quitting smoking represents the single-most powerful way to improve one’s quality of life and life expectancy, and during these uncertain times it can also help limit the spread of the coronavirus.
The writer is is a professor of medicine at Aga Khan University and a consultant pulmonologist at the Aga Khan University Hospital. The opinions expressed are his own.
Published in Dawn, May 12th, 2020