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Coronavirus may be worse for smokers and vapers. And youth won't save you.

The research is new, but evidence suggests smoking may dramatically worsen COVID-19.
Image: Vape smoker
Caleb Banner, a former Queen's Palace vape shop employee, exhales a cloud of vape outside the store in Helena, Mont. on Oct. 17, 2019.Thom Bridge / Independent Record via AP file

In early March, New York City Mayor Bill de Blasio told journalists that a 22-year-old Brooklyn man had been hospitalized with a COVID-19 diagnosis. The man didn’t appear to have any pre-existing conditions; all doctors knew was that he had vaped. “We do think the fact that he is a vaper is affecting this situation,” de Blasio announced to the gathered press. It was a worrisome sign for young smokers.

Now, almost two months later, researchers are still only beginning to investigate the link between vaping and serious complications from COVID-19. According to Dr. Nora Volkow, head of the National Institute on Drug Abuse (NIDA), there appears to be an association, and increasing evidence, of the dangers. Volkow strongly advises people who are vaping to stop. Back in March, the American Lung Association’s chief medical officer, Dr. Albert Rizzo, and the American Nonsmokers’ Rights Foundation also issued warnings.

Researchers are still only beginning to investigate the link between vaping and serious complications from COVID-19.

It's not just a domestic suggestion. The World Health Organization also recently released information from China, where the coronavirus originated, showing that people who have cardiovascular and respiratory conditions caused by smoking or water pipes are at higher risk of developing severe COVID-19 symptoms. In April, NIDA announced that SARS-Cov-2 — the coronavirus that causes COVID-19 —could be an especially serious threat to those who smoke tobacco or marijuana, or vape, regardless of age.

Since COVID-19 is a new disease, we may not know for some time the direct impact and how many of those who suffered from the virus were also smokers or vapers. The research is in its infancy, but we can’t afford to wait for long-term studies. Health professionals must be proactive in educating the public and our youth about the potential dangers and the probable link between vaping, smoking and the increased risk of serious illness or death from the virus.

This is particularly frightening considering the prevalence of smoking and vaping among American youth. According to the Centers for Disease Control and Prevention, each day, over 300 people younger than 18 years become daily cigarette smokers. When it comes to vaping, last year alone we saw a 78 percent increase in the number of high school kids vaping. According to preliminary data from the National Youth Tobacco Survey, 27.5 percent of youth are now using e-cigarettes.

Here’s what we do know: COVID-19 causes significant inflammation of the lung tissue, and the pre-existing lung inflammation and damage caused by smoking or vaping can compound the effects of the virus, putting individuals at risk for serious complications and death.

Lung inflammation and damage caused by smoking or vaping can compound the effects of the virus.

It’s already well known that smoking and vaping can lead to irreversible lung damage. According to the CDC, if smoking continues at the current rate among U.S. youth today, 5.6 million Americans younger than 18 are expected to die prematurely from a smoking-related illness — and that’s not taking into account the new concerns around potential complications from COVID-19.

In the second half of 2019, and into early 2020, more than 2,800 reported cases of severe lung injury related to vaping were recorded across all 50 states. Of that group, some 52 percent of all patients suffering these ill effects are under the age of 25 — a direct correlation to the surge in e-cigarette use among teens and young adults.

We also know that those who vape are filling their lungs with a toxic soup of chemicals. Nicotine, of course. But also: isoprene, a main component of rubber; propylene glycol, used in antifreeze and to de-ice airplanes; formaldehyde, a known carcinogen used to preserve dead bodies; N-nitrosonornicotine, another Group 1 carcinogen; toluene, a solvent used in paint, nail polish and to tan leather; along with nickel, lead, cadmium and many other trace chemicals. Each of these chemicals can wreak havoc on the lungs, causing a host of pulmonary issues that can exacerbate the effects of COVID-19. There are also illnesses that can develop from the use of vapes/e-cigarettes that increase vulnerability to the virus:

  • Bronchiectasis: a life-long condition that thickens and widens the airways, causing mucus to collect due to the inability of the airways to clear. Having this condition makes individuals extremely susceptible to respiratory infections, including COVID-19.
  • Hypersensitivity pneumonitis: an interstitial lung disease resulting in the inflammation of the lungs due to a reaction from an inhalant, or in this case, vape juice. Progression of this condition can require lung transplantation.

While health officials have been warning seniors and those with underlying medical conditions about their risks with the coronavirus, we are doing our young people a disservice if we don’t sound the alarm for them as well. We don’t yet know the exact level of susceptibility people who vape have to COVID-19, but it’s been reported that current smokers face increased risk of disease progression. An early study out of China that looked at the differences between COVID-19 patients who were smokers and nonsmokers, found a higher percentage of smokers had severe COVID-19 illnesses compared to nonsevere symptoms. Another more recent study even found that of those who died of COVID-19, 9 percent were current smokers, compared with 4 percent of those that survived.

We must do everything we can to educate this group about the dangers of smoking and vaping. We can’t assume that they know the risks of smoking and vaping and the effects that could arise as the number of COVID-19 cases increase. And now, as states begin to lift stay at home orders and reopen for business, this is particularly worrisome as people may not be as concerned about catching the virus.

As a nation we are in uncharted territory with COVID-19. We should not wait for the science to catch up. It could take months or years before we have all the answers to how much COVID-19 is exacerbated by smoking and vaping. If we act now, we may be able to save lives, prevent unnecessary hospitalizations and reduce the risk of overburdening our health care system at a time when we must all do our part to end this pandemic.