By Noor Lone
Diana Nergelovic hasn’t left her house in over a month. Her husband, Chuck Nergelovic, now only visits the small Dollar General, avoiding the big shopping area in Kingston that they usually go to, to get their essential items. As a smoker for 24 years, Nergelovic wants to limit her potential exposure to COVID-19 as much as possible.
“Being a smoker, I have a history of bronchitis and pneumonia,” she said. Nergelovic is 43 years old. And even though she is not in the riskiest age group, she is still concerned about her lung history which makes her step into an at-risk group. “Both took a long time to recover from. So I’d like to avoid this virus at all costs.”
“I have thought numerous times about quitting and have even had success once,” she said, “Everytime I try, my anxiety gets worse and I end up going back to it.”
The Centers for Disease Control and Prevention (CDC) reported in a FAQ, updated on April 16, that people may be at risk for more severe illness if they have underlying chronic conditions like chronic lung disease and asthma.
“When you smoke cigarettes, there’s some damage to the lining of your lungs and of your airway,” Dr. Geoffrey Chupp, a pulmonologist at Yale-New Haven Hospital, said, “And the repair process might help enable the virus to cause an infection.”
The prevalence of lung disease like asthma and COPD (chronic obstructive pulmonary disease) was about double in COVID-19 patients than those in the normal population, according to Dr. Chupp.
Dr. Brian Rowe (University of Alberta in Canada) discusses how smoking can increase the severity of a COVID-19 infection.
“If your lungs are not healthy, they are taking all this stuff that’s inhaled into them,” Dr. Brian Rowe, professor in the Department of Emergency Medicine at the University of Alberta in Canada, said, “And they’re fighting it, right? They’re grabbing it and they’re trying to eat it up.”
The thought of a more severe infection is even more daunting for elderly people who have lung complications.
“As an elderly person in the heart of the virus where the rate is the strongest, it is deeply troubling to me,” Gloria Weiss, a 76-year-old from Forest Hills, Queens, said.
“In my lifetime, I have never ever thought I would see anything worse than 9/11, but this is the most awful thing,” she said.
Weiss has smoked all her life and currently smokes six to seven times a day. Her emphysema makes her worry about suffering a more intense COVID-19 illness if she gets sick.
“One of the reasons why Northern Italy was considered a hot spot in Europe was that they’ve had lots of air quality issues, high levels of smoking, and their older age is the second oldest population in the world. So we think that there’s no question that smoking is a risk factor for severe COPD infection and probably COVID infection,” Rowe said.
While older people with underlying medical conditions are more at risk of having serious complications from COVID-19, organizations like The Rockville Centre Coalition for Youth are trying to warn younger people about substance use and its outcomes.
“We’ve been posting information on social media regarding the dangers of vaping and other substance use during this pandemic,” Ruthanne McCormack, the Project Coordinator of the organization, said.
Dr. Brian Rowe says his hospital is doubling down on nicotine replacement therapies, psychotherapy, and their virtual clinic with psychologists to try to get people to stop smoking while the virus is spreading.
“If you don’t smoke, it looks like you recover faster and you have less severe disease,” Rowe said.
Rowe said smoking, whether it’s tobacco or marijuana, diminishes a person’s ability to fight respiratory infections. And he said it’s possible that vaping can cause people’s lungs to be more susceptible to infection.
Due to the novelty of the coronavirus and the lack of research, it’s uncertain if there is a direct correlation between smoking and vaping and contracting the virus.
“However, there is evidence that vaping leads to lung inflammation that might lead to a more difficult course of COVID infection,” Dr. Arnold C.G. Platzker, a pediatric pulmonologist at Children’s Hospital Los Angeles, said.
Studies have shown that cigarette smoking weakens the immune system and damages the lungs. And some research shows that vaping can cause lung inflammation and increase susceptibility to respiratory infections.
“Persons at any age who get COVID suffer a more serious course if they had past exposure to air pollution or suffer from other illnesses such as asthma or diabetes,” Platzker said.
But vaping causing chronic lung problems or COVID-19 has yet to be shown in longitudinal studies, making it unclear if there is a connection.
“E-cigarettes have been a potential candidate for chronic lung diseases,” Dr. Jean Bourbeau, a respirologist at the Montreal Chest Institute of the MUHC, said, “ But for COVID and e-cigarettes, there is no data to substantiate this.”
However, a recent study from a France hospital showed that the infection rate for smokers was lower than non-smokers.
The study from Pitié-Salpêtrière hospital in Paris suggested that the infection rate for COVID-19 patients who were smokers was less than non-smokers. The study, released on April 21, suggested nicotine may be preventing smokers from getting COVID-19.
“Smoking has severe pathological consequences and remains a serious danger for health,” the study said, “Yet under controlled settings, Nicotinic agents could provide an efficient treatment for an acute infection such as COVID-19.”
The study and media coverage of the study led France to ban online sales of nicotine replacements, in an attempt to prevent “excessive consumption or misuse” of nicotine substitutes and guarantee a supply of for people trying to quit smoking, according to a draft legal text released on April 23.
French researchers are planning to test nicotine patches on coronavirus patients, so it is not a confirmed method to prevent contracting the virus.
New research and studies are currently being conducted to find prevention tools and treatments for COVID-19. But evidence from medical officials and government organizations like the CDC and NIH shows that smokers who become infected with coronavirus are highly likely to develop more severe cases of the COVID-19 respiratory disease.