The New York state chapter of the AAFP cites grim statistics from China on COVID-19 disease progression in smokers vs nonsmokers.
The New York State chapter of the American Academy of Family Physicians (NYAFP) on March 22, 2020 called for an immediate ban on the sale of all tobacco and vaping/e-cigarette products.
It was the same day, according to an AAFP new release, that New York’s governor Andrew Cuomo enacted the state’s "New York State on Pause" executive order and that the state ranked as the hardest hit to date by the SARS-CoV-2 pandemic.
"As our state and country struggle to respond to the rapidly evolving and escalating COVID-19 pandemic affecting our residents and straining our health care system, mounting evidence demonstrates the link between tobacco use and increased risk for progressive COVID-19," said Barbara Keber, MD, president of NYSAFP, in the chapter’s March 22 statement.
"Now more than ever, it is critical for the state and medical community to take actions to prevent our youth from ever using these highly addictive, deadly products and to help our patients to reduce their risks through FDA-approved cessation and telehealth during this pandemic," added Keber.
Smoking is a COVID-19 risk factor
The NYSAFP statement pointed to results of a study from China that compared disease course in patients with COVID-19 who were nonsmokers with those who had a history of smoking/tobacco use. Of infected patients whose health either improved or was stabilized, nontobacco users recovered more successfully; tobacco users were 14 times more likely to have COVID-19 progression, requiring more extensive treatment and hospitalization.
Tobacco users in China infected with COVID-19 were 14 times more likely to have disease progression that required more extensive treamtent and hospitalization.
Smoking has deleterious effects on immunity and as such is included in the CDC’s list of underlying conditions that increase risk for becoming infected with COIVD-19.
The World Health Organization also identifies smoking as a specific risk factor for COVID-19 and in a Q&A on smoking and COVID-19 says that people who smoke may already have lung disease or reduced lung capacity which would significantly increase the risk of serious illness in the case of infection. Also, the act of smoking means that one’s fingers-and possibly contaminated cigarettes) are in contact with the lips, greatly increasing the possibility of virus transmission from hand to mouth.
Second-hand smoke, too, increases the risk of acute respiratory infections and so smoking cessation efforts would help minimize the risks of the pandemic to both smokers and those exposed tobacco use.
“Since smoking has been a demonstrated risk factor for COVID-19 disease progression, which leads to increased use of medical services, especially ventilators, our hope is that by reducing the number of smokers, we can further reduce the stress/demand on the already limited supply of medical resources," said Jason Matuszak, MD, president-elect of the NYSAFP, in the AAFP News release.
Matuszak recommended that in addition to encouraging patients to quit using tobacco, the current health crisis can offer a platform to discuss making other positive life changes.
"Use exercise as a stress relief instead," he advised. "Most people have a lot more time now to focus on healthy habits, even in the face of stressful situations."
For more COVID-19 coverage for primary care, visit our COVID-19 Resource Page.