What smokers and vapers need to know about COVID-19

People with certain underlying health problems are more likely to become seriously ill with the 2019 novel coronavirus disease, COVID-19. That includes diabetes and asthma.

But what about people who smoke or vape? 

If your smoking or vaping has not led to a chronic disease yet, there’s not enough data to make a confident assertion about your risk for COVID-19. But you should still be extremely careful, and do all you can to quit now.

“We know that smokers are at higher risk for respiratory infections,” says George Eapen, M.D., Professor in MD Anderson’s department of Pulmonary Medicine. “Vaping could be even worse.”

That’s because smoking damages your lungs’ defense system and impairs your immune system. And vaping can lead to immediate inflammation and lung injury.

Why do smokers get more respiratory infections?

Your lungs rely on a complex mucous transportation system to stay clean and clear of debris.

Tiny structures called cilia continuously transport mucous up and out of the lungs. It is then swallowed or expelled by coughing. This process is key to keeping your lungs healthy.

“When you smoke a cigarette, it temporarily stuns these structures and they cannot clear your lungs as well,” says Eapen. “We think this is one reason why smokers get sick more often.”

Another reason is that hot smoke from cigarettes or cigars disrupts the cells of your sinuses, nasal passage and throat. This disruption of the cell barrier may make you vulnerable to infections, including respiratory viruses. 

Each infection you get causes a little more damage to your lungs.

“It’s like Russian roulette. We don’t know exactly which infection will lead to serious problems,” says Eapen. “But the one thing you can do is stop adding additional burden to your lungs.”

Those with smoking-related illnesses like COPD or heart disease may face more complications if they contract a COVID-19 infection.

What about vaping?

During a vape session, you take an aerosol of chemicals and nicotine into your lungs. The long term risks are unknown but many short term problems have been identified.

E-cigarettes can make asthma worse, and cause coughing and wheezing. The most serious risk is for vaping associated lung injury or EVALI.

Experts think this is caused by a bad reaction to untested ingredients. An outbreak in 2019 was linked to vitamin E and tetrahydrocannabinol or TCH. 

“The lung scans of people who have vaping associated lung injury look identical to people with COVID-19,” says Eapen. “So if people are vaping, I would say absolutely stop it now.”

Until vaping products are properly regulated, we don’t know for sure what they contain or what harm they cause. The important thing to remember is that any existing lung damage is likely to increase your risk for COVID-19 complications.

The less damage you do to your lungs through either smoking or vaping, the better your chances of surviving a COVID-19 infection.

You can quit vaping and smoking

The best way to quit smoking is to use a combination of medications and counseling.

You can get free phone and text support through the Quitline in your state by calling 800-784-8669 or text QUIT to 47848. Visit www.SmokeFree.gov for more information.

Programs designed for young people and teenagers also are available:

• Truth Initiative
• Smokefree Teen

“There’s not much we can do about COVID-19 right now except practice hand hygiene, social distancing and reduce our known risk factors,” says Eapen. “Smoking and vaping are risk factors you can change.”

Learn more about COVID-19 and precautions MD Anderson is taking.