Stop smoking in the time of Coronavirus (COVID-19)

“If ever there was a time to quit smoking – that time is now,” says Savera Kalideen of the National Council against Smoking (NCAS). “With the threat of the coronavirus pandemic looming large, now is the time to take care of your own lungs by not smoking cigarettes, shisha, vaping or using e-cigarettes. Also, with more people spending increased amounts of time at home especially during lockdown, we must make sure children and non-smokers are not exposed to harmful secondhand smoke that could make them more susceptible to respiratory illnesses.”

 While the novel coronavirus pandemic is evolving too rapidly for conclusive evidence on the effect of tobacco smoking on an individual’s susceptibility to the novel coronavirus (COVID-19) infection to have emerged, Kalideen says there is already overwhelming evidence that people who smoke are at increased risk of getting lung and chest infections. “If smoking makes you more susceptible to lung infections caused by respiratory viruses, such as influenza, or bacteria as in the case of tuberculosis, you may be more vulnerable to contracting COVID-19 compared to people who don’t smoke.”

Smoking also fundamentally affects the immune system, making it harder to fight infection. Existing evidence on smoking suggests that smokers with damaged lungs and weakened immune systems would be likely to be more severely impacted by COVID-19 if they do become infected, just as they are with influenza and tuberculosis.

South Africa has one of the highest rates of HIV infections in the world with 7.7 million people living with the disease, making us extraordinarily vulnerable. HIV has made people more susceptible to tuberculosis and 60% of people in the country with HIV also have TB.  The Academy of Science of South Africa has said that individuals with HIV are already eight times more likely to be admitted to hospital for influenza-linked pneumonia. Scientists do not know how Covid-19 will affect people with HIV and TB, although there is concern about their likely increased risk. While people of all ages can contract Covid-19, the elderly and those with underlying conditions, such as lung disease, are most at risk of experiencing more severe disease progression according to the World Health Organization (WHO).

WHO statistics show that in South Africa (SA) alone, smoking already results in more than half of lung cancer deaths and over 20% of tuberculosis (TB) deaths. ^“As with many lung-related diseases, tobacco use increases the risk of contracting TB and experiencing recurrent TB, as well as impairing patients’ response to treatment,” says Kalideen.

Dr Catherine Egbe, Specialist Scientist (Tobacco Control) of the Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, explains that while current evidence does not indicate that smokers are more likely to contract COVID-19 than non-smokers, scientists have found that smokers are more likely to show disease progression or complications when they contract the virus. Dr Egbe adds that these findings should not come as a surprise.  “It is well-documented that smokers are at higher risks of cardiovascular diseases and COVID-19 is known to also affect the cardiovascular system.    Global research suggests that older people and people with chronic health conditions, including cardiovascular disease, are at higher risk of dying from COVID-19 than the average population.”

Second-hand smoking (SHS) is known to cause harm. Professor Pamela Naidoo, CEO of the Heart and Stroke Foundation South Africa highlights that in a recent study in the Western Cape Province, nicotine was found in the system of newborn infants and non-smokers. Naidoo says that exposure to SHS damages lungs and depresses the immune system increasing susceptibility to chest and respiratory infections. “Protect the lungs of those around you, particularly children and the elderly, and ensure they are not exposed to secondhand smoke.”

There is a light at the end of the tunnel for smokers who quit now. “People who smoke are at increased risk of lung infections in general, but the lungs do heal over time when people stop smoking,” Dr. Egbe says.  “While it takes about 10 to 15 years for smokers who quit to regain full health equal to that of someone who has never smoked, smokers who quit begin to experience physiological changes within hours of quitting.  Over time, their susceptibility to lung infections like bronchitis and pneumonia also decreases.”

The message from NCAS, CANSA, the Heart and Stroke Foundation and the South African Medical Research Council in the time of COVID-19 is clear. Stop smoking now and do the best you can to boost your immune system and improve your lung health.