Smoking increases the risk of respiratory infections, such as colds, flu, pneumonia, and tuberculosis. Smoking may also contribute to coronavirus disease 2019 (COVID-19) complications.

Smoking and the risk of contracting SARS-CoV-2 and COVID-19

Numerous previous studies have confirmed the deleterious impact smoking has on the lungs. The harmful chemicals in tobacco smoke affect both the epithelium and vascular endothelium of the lungs. More specifically, these substances appear to directly damage the epithelial cells, which subsequently impacts the epithelial barrier and mucociliary clearance. In addition to these direct effects, these damaged cells release modified molecules into the lungs, which stimulate specific receptors that ultimately activate innate and acquired immune responses. Despite the growing interest in determining the relationship between smoking and COVID-19, the overwhelming caseload of COVID-19 patients has limited the ability of researchers to dedicate time to this investigation. Nevertheless, a recent The Lancet Respiratory Medicine study examines the potential effects of tobacco use on severe acute respiratory virus coronavirus 2 (SARS-CoV-2) transmission, the pathophysiological changes due to tobacco use, as well as the effects of tobacco on immune and inflammatory responses to COVID-19.

The objective of the current study was to determine whether tobacco users have a greater preponderance of developing symptomatic SARS-CoV-2 infection, as well as whether this patient population is at a higher risk of severe COVID-19 or associated mortality, long COVID, or a different vaccination response. The researchers analyzed the behavioral mechanisms associated with tobacco consumption on COVID-19 and inflammatory immune responses. Furthermore, they also screened risk factors for the development of public health policies and patient care delivery. To identify articles on COVID-19 and tobacco use, the researchers searched PubMed and Embase databases. Web of Science, PsycINFO, CINAHL, and Sociological Abstracts were also searched, while duplicates and opinion pieces were removed. PubMed, Web of Science, Embase, CINAHL, PsychINFO, and Sociological Abstracts were searched again for articles on COVID-19 and tobacco use that were published between December 9, 2020, and August 30, 2021. Taken together, a total of 2,151 articles were selected for review.

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