Coronavirus Disease 2019 and Smoking

Abstract

Smoking is associated with one of five deaths in the United States. Multimodality tobacco treatment increases rates of successful cessation by at least 20%. The coronavirus disease 2019 pandemic has put a halt to many inpatient and outpatient medical visits that have been deemed nonessential, including tobacco treatment. The transition to telehealth has been wrought with challenges. Although data on the association between coronavirus disease 2019 and tobacco products are mixed, the overall health consequences of tobacco point towards increased risk of morbidity and death that is associated with the virus. This leaves smoking as one of the few readily modifiable risk factors in an environment understandably not set up to prioritize cessation. A military health facility on Fort Eustis in Virginia runs a successful tobacco treatment program and adapted it to pandemic times. This article describes the process and lessons learned from this initiative. The model is applicable and scalable to government and civilian health centers as health care adapts to a new normal.

Health Inequalities During COVID-19 and Their Effects on Morbidity and Mortality

“…20 Access to healthcare is also limited in rural areas, often due to limited providers and lack of resources, 21 making it more difficult for COVID-19 patients to obtain the appropriate care they need. 22 This is particularly important when the need for COVID-19 testing grows beyond what is reimbursable, forcing some rural providers in private healthcare systems like that of the USA to stop providing care to those who are uninsured. Taking all of this into account, it is crucial that measures are set in place to try and limit the effect of the aforementioned factors on COVID-19 outcomes, albeit some are difficult to control.…”

“… 46 Smoking is known to increase mortality in patients with COVID-19. 22 Public healthcare systems such as the NHS benefit from free smoking cessation services, 47 but the majority of private systems do not. Thus, governments can step in by subsidizing or waiving the fee for smoking cessation services, in aims of lowering the risks of smoking-related diseases.…”

Impact of Smoking on Women During the Covid-19 Pandemic

“…Stress and worsening of mental health, associated with this pandemic, are well-known predisposing factors for increase in smoking (quantity and frequency) as well as relapses (56). The COVID-19 pandemic disrupted ongoing clinical trials of smoking cessation and forced research teams to rapidly implement changes to assure access to counseling and monitoring by phone or internet communication tools (57,58). Smoking cessation recovers airway ciliary clearance and immune function, being strongly encouraged as a public health measure to limit the global impact of COVID-19 (59).…”

Correlation between adult tobacco smoking prevalence and mortality of Coronavirus Disease-19 across the world

“…19 It leads to an increase in vasoconstriction, vascular permeability, inflammation, and acute lung injury. 20 There is also evidence more circulating ACE2 in men which provides evidence for gender-based variations in disease severity. 21 Smoking increase the risk of lung damage by destroying ciliated epithelium and disrupts its function which protects the lungs through the production of mucus and rapid clearance of pathogens.…”