With a vaccine already widely available worldwide we have already started seeing decreases in COVID numbers and the start of the return to normal that everyone has been hoping for this whole year and a half. But while we are getting ready for that new normal, now is a good time to reflect on how we handled ourselves during the previous heights of the pandemic and its resurgences. Most specifically, because COVID is a respiratory virus, how have we both individually and as a country been working to improve our lung health?

While the CDC and WHO provide the guidance that smoking increases danger from COVID and that tobacco cessation greatly reduces overall risk, this advice comes with little in the way of studies to back it up. It is considered common knowledge that smoking is bad for your health, but in the case of COVID there are not any widely circulated or peer reviewed studies indicating that smoking worsens COVID symptoms or infection rates. There are, however, plenty of articles interested in the topic that have opinions on the matter.

Rather than look at the laundry list of journalistic opinions, let us take a more critical look at the information given by the WHO and CDC. The CDC actually has very little to say about smoking as a risk factor for COVID. When looking at their page for COVID risk factors, smoking is listed as a condition which poses increased risk of severe illness; however, the individual article on smoking as a risk condition merely states that it is a risk factor and that those that do smoke should quit. It then lists several resources for those interested in quitting.

The WHO explains more thoroughly its reasoning in listing smoking as a risk factor. The WHO page on smoking in correlation with COVID now states that there are up to thirty-four peer reviewed studies on the matter of smoking and COVID. And while the focus of these studies varies their general point of interest is the same. The most clear and understandable information presented by the WHO on this matter comes from the twenty-six peer reviewed and verified observational studies conducted on hospitalized patients with COVID-19. These studies confirm a prevalence of individuals who smoke among those who require hospitalization for the disease. In other words, initial studies seem to point to smoking as a powerful and clear factor in severe COVID symptoms and increased need for hospitalized care.

With these explanations of the increased dangers of smoking, the logical conclusion, given the increased health risks, would be that the number of habitual smokers has decreased. There are other factors of course. Studies indicate that the number of habitual smokers, particularly first time smokers, has increased over the course of the pandemic. One particular study published in the Journal of Community Health, posits that the increase in smokers is due to smoking as a coping and stress relief method. The same study, more optimistically, shows that the cessation rate of smokers has increased from 23.7% to 31.1%, meaning that people that already smoke are deciding to quit smoking at a faster rate. This study looked most specifically over the period of time in which the pandemic has taken place. While the study implies that the danger of severe COVID symptoms has increased the rate of smoking cessation, it suggests that further measures be taken to assist in aiding smoking cessation for those interested in improving their lung health. The primary suggestion is more counseling for those attempting to quit smoking, as the primary complaints for those attempting to quit were psychiatric in nature.

There have been a number of other factors at play during this period of time as well that have impacted the number of habitual smokers and the rate of smoking cessation. As the pandemic has brought public health forward as a universal concern, organizations like the WHO and CDC have been given a larger platform to advocate against smoking and tobacco use. Alongside this bolstering of voices against tobacco use, tobacco companies, primarily e-cigarette companies, have been facing massive ethics and health allegations that are popping up alongside other pandemic concerns for these same corporations. These factors have also led to better personal health decisions, as average Americans are receiving more information about these issues than before.

Hopefully future studies will show that Americans have made even more progress regarding personal health, especially lung health. According to the CDC, cigarette smoking is responsible for over 480,000 deaths a year in the United States alone. This used to be an impressive statistic, but has since been overshadowed by the number of domestic COVID deaths. Even with vaccines available, the COVID pandemic has provided us some insight into how the problem of smoking can become worse and what other unforeseen risks we might be taking when we smoke. Please consider getting vaccinated if you have not already been, as those with weaker lungs than yours may not have the option.

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