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Contrary to Recent Headlines, Evidence Indicates Smokers are at Greater Risk, Not Protected, from COVID-19

Statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids
April 24, 2020

WASHINGTON, D.C. – Misleading information on the relationship between smoking and COVID-19 has been reported by the media following the release of two linked papers on an open-access website, Qeios. As a result, it has been widely and inaccurately reported that these papers demonstrate that smokers are at lower risk of COVID-19 and by implication that nicotine may offer protection from COVID-19. This conclusion is inconsistent with the growing number of studies that smokers are at greater risk of suffering more severe consequences of COVID-19, has been derived from results that have not been peer-reviewed, and does not stand up to scientific scrutiny.   

The French statistics released on Qeios scientifically do not permit any form of credible conclusions on smoking, nicotine and COVID-19. The studies have significant weaknesses, including the fact they rely on a very small sample size that does not involve a representative sample, does not take into account data regarding ex-smokers, or account for significant potential confounding factors. 

According to an analysis by the University of Bath, many of the outpatient subjects in the first paper are healthcare workers who are more likely to get infected in a hospital rather than in the community and who also smoke at below average rates. In addition, the study was conducted in an area of France with below-average smoking rates and the most severe cases (those admitted to ICU) were excluded from analysis. While the proportion of current smokers in the study was lower than in the French population as a whole, when ex-smokers are taken into account, the proportion is higher. For these reasons and others, the information posted on Qeios cannot be used to draw any conclusions about the relative risk of smokers and non-smokers acquiring COVID-19. 

There is conclusive evidence that smoking increases the risk for respiratory infections, weakens the immune system and is a major cause of a number of chronic health conditions, including chronic obstructive pulmonary disease, heart disease and diabetes. In addition, there is growing evidence that vaping can also harm lung health. There is also increasing evidence that individuals who suffer from these very same diseases are at far greater risk from COVID-19. These factors all support the conclusion that smokers, and in all likelihood vapers, are at greater risk when confronted with COVID-19, and are completely inconsistent that claims that being a smoker somehow reduces the risk of COVID-19.

Tobacco use is the world’s leading cause of preventable death, killing more than 8 million people around the world each year. The evidence is clear: tobacco use kills up to half of all lifetime users. Smokers and vapers looking to protect themselves from COVID-19 should make every effort to quit at this time as research has shown that quitting smoking rapidly improves lung function.

While public health experts and governments around the world face the enormous health and economic toll of the COVID-19 pandemic, tobacco companies continue to exploit the pandemic to spread misinformation and promote deadly tobacco products.  In several countries, tobacco companies and their allies have spread false information that tobacco use or vaping will protect users from COVID-19. This information is false and dangerous.

Tobacco companies will stop at nothing to sell more products, even if it means capitalizing on a pandemic. Never has it been more important for the public and policymakers to see the tobacco industry for what it is: an industry of death and disease.