Are people who smoke or vape at more risk from COVID-19?

Yes. If you smoke or vape and get the COVID-19 virus, you increase your risk of developing more severe COVID-19 symptoms. Smoking and vaping lower the lungs’ immune response to infection. COVID-19 attacks the lungs, and people who smoke are at higher risk of developing lung infections along with older adults over the age of 65, individuals with compromised immune systems, and individuals who have underlying medical conditions such as hypertension, heart disease, diabetes, or lung disease.

Bottom line: Your lungs work better when you stop smoking or vaping. You can learn more here.

What happens to your lungs when you smoke or vape?

Human lungs are very delicate organs. When you smoke or vape, you are inhaling a number of chemicals and particulates into your lungs. We know that smoking and vaping are associated with an inflammatory process in the lining of the lungs, the very place where COVID-19 causes its most serious damage.1 2 3 4 5 Smoking, vaping, and COVID-19 all harm the lungs.

Is it possible to spread coronavirus by smoking, vaping, or hookah?

Yes. When someone is smoking or vaping, they are repeatedly putting their hands to their mouths and faces. If the virus is on their hands, smoking or vaping can increase the chance that it will find its way into the person’s system. The risk can also be increased if the tobacco items are shared. Hookah or water pipe use often takes place in groups. The mouthpiece, the hose, and the water in the hookah can harbor and transmit bacteria from one user to another when shared.6 This is a serious indicator that the COVID-19 virus can also spread through hookah sharing in the same way.

Should someone quit smoking or vaping during the COVID-19 pandemic?

COVID-19 and smoking may be a deadly combination. Research showed that, compared to nonsmokers, smokers with COVID-19 are twice as likely to be admitted to the intensive care unit, need mechanical ventilation, or die.7 Your lungs work better when you stop smoking. Vaping compromises lung function during a time when we need our lungs at their healthiest. Vaping is associated with an inflammatory process in the lining of the lungs, the very place where COVID-19 causes its most serious damage.1 2 3 4 5

There is help available for those who want to quit. The California Smokers’ Helpline has been helping people quit smoking for more than 25 years. The Helpline’s caring counselors are ready to develop a personalized quit plan that’s right for you. There are lots of ways to connect – visit KickItCA.org or call 1-800-300-8086.

Should I be worried about my child who vapes, if they get COVID-19?

Yes. We know that smoking and vaping are associated with an inflammatory process in the lining of the lungs, the very place where COVID-19 causes its most serious damage.1 2 3 4 5 We strongly encourage your child to stop vaping – there has never been a better time to protect lung health. But you don’t have to do this alone – there is support for parents who want to help their child stop vaping. Visit FlavorsHookKids.org to get information, suggestions, and resources on how to approach and talk to your child about vaping, as well as quit programs that are specifically designed to help teens quit vaping. You can do this – your child needs his or her lung health now more than ever.

Is the rumor true, from the research out of France, that nicotine protects smokers from COVID-19 and could be used as a possible treatment option?

No, it is not true. Smokers are considered at higher risk for a more severe illness for COVID-19. Unsupported claims have no place in public health. The article from France about smokers protected from COVID-19 has significant research limitations, including being a cross-sectional observational study, having a small sample size from one hospital, was not peer-reviewed, which is standard for any scientific research, and one of the authors in a similar opinion piece has a long history with tobacco funding.12 Tragically, this type of unfounded research and inflammatory headline puts people’s lives at risk.

A large study published in the New England Journal of Medicine from Wuhan, China, showed that, compared to nonsmokers, smokers are twice as likely to be admitted to the intensive care unit, need mechanical ventilation, or die from COVID-19.11 In short, if you smoke, you are at a higher risk for a more severe illness if you are infected with the coronavirus.

Quitting smoking/vaping is hard, especially during stressful times. What can I do?

Everyone is feeling more pressure and stress with what’s going on, but smoking or vaping isn’t the support that we need. Many people think that smoking or vaping nicotine helps with stress and is calming, but it actually puts more stress on the body. Nicotine is a highly addictive neurotoxin and a stimulant that makes the heart work harder.

Nicotine withdrawal symptoms can mimic anxiety, producing even more stress. There are better ways to take a break from the stresses we’re all feeling. Call a friend, find a video that makes you laugh, even just take some deep breaths. If you or anyone you know need help in quitting smoking, please visit NoButts.org or call for free at 1-800-NO-BUTTS which will connect you to the California’s Smokers’ Helpline. The Helpline now has services specifically for people who vape. There are lots of ways to connect – visit NoVapes.org or 1-844-8-NO-VAPE. The Helpline has been providing free, personalized support to people who want to quit for more than 25 years, and in six languages. The Helpline’s caring counselors are ready to help you start or re-start your quit journey.

Is it possible to spread the coronavirus through secondhand smoke or e-cigarette/vape aerosol?

When people are smoking or vaping, they are also exhaling particulates from deep within their lungs into the environment around them. If they share their living space with anyone else, they are also being exposed to whatever is being exhaled.

If I’m exposed to secondhand smoke, am I more at risk from COVID-19?

Secondhand smoke harms your lungs,8 and weakened lungs can lead to more severe symptoms of COVID-19.9 Secondhand smoke exposure also impairs immune function in both children and adult nonsmokers, which increases susceptibility to infection.8

How can I protect myself and my family from secondhand smoke (a family member smokes or my neighbor smokes) during the stay-at-home order?

This isn’t a time to get angry with your smoking or vaping family member or neighbor. Now is the time for understanding and compassion. Dealing with stress can make it hard for people to quit smoking and vaping, or to stay quit. For some, it could even lead to starting for the first time or to using more tobacco than they would normally.

We all need healthy lungs now more than ever. When you’re exposed to secondhand smoke, it harms your lungs.8 Damaged lungs can lead to more severe symptoms of COVID-19.10 11 Click here for more resources and information about the dangers of secondhand smoke and vape exposure.

More articles on COVID-19:

• Protect yourself from COVID-19: Stop smoking and vaping now by Elisa Tong, MD, MS Associate Professor of Internal Medicine, University of California, Davis.
• Hookah and COVID-19: How hookah puts you at risk by Wael Al-Delaimy MD Ph.D. Professor, Department of Family Medicine and Public Health, University of California, San Diego.