Smoking, vaping and substance abuse put people at higher risk of coronavirus infection as disease attacks lungs
COVID-19, the disease caused by the new coronavirus, might hit people who smoke, vape or have drug addiction problems the hardest, warn experts. The warning comes after the Centers for Disease Control and Prevention (CDC) stated that smokers are at a higher risk, thanks to their compromised immunity.
Experts are now alerting the research community to pay attention to this vulnerable group. "Because it attacks the lungs, the coronavirus that causes COVID-19 could be an especially serious threat to those who smoke tobacco or marijuana or who vape," Dr Nora Volkow, director of the National Institute on Drug Abuse wrote in a blog post published on March 24.
"There's no better time to quit smoking than today. Active smokers are at increased risk for COVID-19 to cause them problems. So, again, there is no better time to quit than today," Dr Neal Patel, a Mayo Clinic pulmonologist and critical care medicine specialist, said in a blog post.
Others at higher risk of contracting the disease include people above 65 years of age and those with underlying health conditions such as heart problems and diabetes.
How smoking makes people vulnerable?
Smokers have a higher risk of developing a kind of respiratory problem called acute respiratory distress syndrome (ARDS), usually seen in patients with severe COVID-19. These patients cannot breathe and require a ventilator to pump oxygen in and out of their bodies.
Additionally, smokers tend to have a compromised immune system. This is because it destroys a type of a lung cell called cilia, responsible for blocking invaders like the new coronavirus.
"The cilia are tiny, hairlike follicles that help to trap viruses and debris, and move them up and out of your lungs so they don't stay there and cause issues. The cilia act as one of the main defense systems against infection. Without that cilia, smokers, unfortunately, are a little bit defenseless. And it explains why some smokers who develop common colds may develop prolonged coughs for weeks to months. Somebody who has healthy lungs may bounce back more rapidly," Dr Patel said.
What about vaping?
While there is not much evidence to tie vaping with COVID-19 risk, researchers say certain components from e-cigarettes can harm the lungs. "Emerging evidence suggests that exposure to aerosols (minute particles) from e-cigarettes harms the cells of the lung and diminishes the ability to respond to infection," Dr Volkow wrote.
Giving an example, Dr. Volkow explained, when mice infected with the influenza virus were exposed to these aerosols, they had enhanced tissue damage and inflammation. Inflammation in the lung hinders the functioning of the lung, making it harder for people to breathe.
Because vaping is a recent phenomenon, less is known about its harmful long-term effects as compared to smoking tobacco.
E-cigarettes came under the scanner last year after its users developed severe lung damage. The CDC had reported more than 2,000 cases of lung damage and 68 deaths.
Further investigations revealed that vaping products containing an additive called vitamin E acetate, and THC, the psychoactive component of marijuana, were the culprits.
Additionally, researchers are yet to understand if vaping can lead to a lung disease called chronic obstructive pulmonary disease (COPD). Having COPD makes it hard to breathe. Hence, patients with the condition tend to be the worst affected by COVID-19.
"Research suggests that vaping may also harm cilia in the lungs," Dr Patel said in a blog post. "I recommend people stop vaping to maintain lung health and reduce the risk of developing the severe disease if they contract COVID-19," he added.
Why is substance abuse risky?
Opioids can decrease the levels of oxygen in the blood. People on drugs are severely hit by respiratory problems. And COVID-19, which reduces the lung capacity, endangers this population, explained Dr Volkow.
Another group at risk are those with a history of methamphetamine use. The drug has been shown to decrease blood flow in the lungs, putting them at a higher risk for a respiratory illness like COVID-19.
"Other risks for people with substance use disorders include decreased access to health care, housing insecurity, and a greater likelihood for incarceration. Limited access to health care places people with addiction at greater risk for many illnesses, but if hospitals and clinics are pushed to their capacity, it could be that people with addiction — who are already stigmatized and underserved by the healthcare system — will experience even greater barriers to treatment for COVID-19. Homelessness or incarceration can expose people to environments where they are in close contact with others who might also be at higher risk for infections," wrote Dr Volkow.
What current research says?
Data from China suggested that men are more vulnerable to the disease than women. This led researchers to question whether increased smoking among men had something to do with it.
Dr Brian Labus from the University of Nevada, Las Vegas, had earlier told MEA WorldWide (MEAWW) that respiratory diseases often are much worse among smokers. "Over half of Chinese men smoke while only about 1% of Chinese women do. Smoking is also more common in China in older people than younger people," he added.
One study analyzed information from the first 8,000 cases in China and found that smoking could be putting men at risk of death.
Another study from China observed that the odds of disease progression (including to death) were 14 times higher among people with a history of smoking compared to those who did not smoke.
Given the evidence so far, experts are urging people to give up smoking. "This would also be a good time for cities, states private employers and even individual families to strengthen their smokefree laws and policies – including e-cigarettes -- to protect nonsmokers from the effects of secondhand smoke and aerosol on their lungs and to create an environment that will help smokers quit," DR. Stanton A. Glantz, Director, Center for Tobacco Research Control & Education, wrote in a blog post.