COVID-19 Digest: Could Cigarette Smoking Actually be Protective Against COVID? - The Emergency Medical Minute

COVID-19 Digest: Could Cigarette Smoking Actually be Protective Against COVID?

Host: Elizabeth Esty, MD.

Smoking is known to increase both susceptibility and severity of all manner of colds and pneumonias, so you’d think the world’s 1.1 billion smokers would be at risk in this pandemic of what at first seemed to be a just a respiratory virus. 

What’s more, tobacco smoking increases risk for COPD, diabetes and coronary disease, so it may increase risk for more severe COVID indirectly. So it’s remarkable that preliminary evidence suggests that smokers may be less likely to be harmed by COVID than non-smokers. A story that’s gotten a fair amount of attention in the media concerns reports from France that smoking may be protective against COVID. We took a closer look and found that similar reports are coming in from across the globe, including the US. We decided to take some time to look at papers and attempt to explain this relationship. 

Research By: Elizabeth Esty, MD.

Sound Editing By: Nathan Novotny.


[1] Miyara M, Tubach F, Pourcher V, et al. Low incidence of daily active tobacco smoking in patients with symptomatic COVID-19. Qeios. April 2020. doi:10.32388/WPP19W.3

[2] Guan W, Ni Z, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. New England Journal of Medicine. 2020;382(18):1708-1720. doi:10.1056/NEJMoa2002032

[3] Chow N, Fleming-Dutra K, Gierke R, et al. Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019 — United States, February 12–March 28, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(13):382-386. doi:10.15585/mmwr.mm6913e2

[4] Richardson S, Hirsch JS, Narasimhan M, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. April 2020. doi:10.1001/jama.2020.6775

[5] Berlin I, Thomas D, Le Faou A-L, Cornuz J. COVID-19 and Smoking. Nicotine Tob Res. doi:10.1093/ntr/ntaa059

[6] Farsalinos K, Niaura R, Houezec JL, et al. Editorial: Nicotine and SARS-CoV-2: COVID-19 may be a disease of the nicotinic cholinergic system. Toxicology Reports. doi:10.1016/j.toxrep.2020.04.012


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