Smokers and vapers suffer more severe outcomes from COVID-19

People who are smokers or vapers at the time of hospitalization for COVID-19 are more likely than non-smokers/non-vapers to suffer severe complications from their SARS-CoV-2 infection.

The findings were published on July 26,2022 in PLOS ONE.

“In general, people who smoke or vape tend to have a higher prevalence of other health conditions and risk factors that could play a role in how they are impacted by COVID-19. However, the robust and significant increase in the risk of severe COVID-19 seen in our study, independent of medical history and medication use and particularly among young individuals, underscores the urgent need for extensive public health interventions such as anti-smoking campaigns and increased access to cessation therapy, especially in the age of COVID,” said senior author, Aruni Bhatnagar, Ph.D., FAHA, a professor of medicine, biochemistry and molecular biology at the University of Louisville in Louisville, Kentucky. “These findings provide the clearest evidence to date that people who smoke or vape have a higher risk of developing severe COVID-19 and dying as a result of SARS-CoV-2 infection.”

The investigators analyzed data on adult subjects (>18 years old) who were hospitalized with COVID-19 in hospitals across the USA between January 2020 to March 2021. The data came from the American Heart Association’s COVID-19 CVD Registry.

They classified subjects as smokers if they reported current use of traditional cigarettes or of e-cigarettes.  

They defined the endpoint of “severe outcome” was either death or the use of mechanical ventilation.

Of the 31,545 subjects in the registry, 6,717 were 1:2 propensity matched (smokers vs. non-smokers) for age, sex, race, medical history, medications and timeframe of hospital admission.

The researchers reported that smokers were 45% more likely to die and 39% more likely to receive mechanical ventilation compared to non-smokers.

The authors concluded, “Independent of sociodemographic characteristics and medical history, smoking was associated with a higher risk of severe COVID-19, including death.”