COVID-19, Education, Health Impact, News, Protect Yourself, Smoking

The Dangerous Intersection between Smoking and the Pandemic

10 · Apr · 2021
silhouette of a person smoking

By Byambasuren Enkhee

We know that smoking nicotine products poses many health risks. But smoking during a pandemic caused by a lung-attacking  virus exacerbates the risk of severe illness. During the pandemic, more people may feel compelled to take up smoking for the first time or continue the habit as a self-soothing practice. This article explains some of the health effects of smoking, reasons why people smoke, and helpful and sustainable actions (other than smoking) that can help you deal with stress during the pandemic. 

According to the World Health Organization, COVID-19 is a respiratory illness caused by a novel coronavirus, SARS-CoV-2, infection. The illness can cause several different lung complications depending on the severity of infection, pre-existing health conditions, and the form of treatment received. COVID-19 can cause pneumonia, acute respiratory distress syndrome (a type of lung failure that happens if pneumonia progresses), or sepsis in the most severe cases. A study of 44,000 people with COVID-19 in China found that 81% of study participants showed mild to moderate symptoms (including mild pneumonia), 14% showed severe symptoms, and 5% showed critical symptoms (“respiratory failure, shock, or multiorgan system dysfunction”). 

Exposure to environmental air pollution or tobacco smoke increases the risk of severe COVID-19 illness. Since smoking irritates the lungs, the immune system could be overwhelmed, and it might be “harder for the body to fight off coronaviruses and other diseases.” 

The World Health Organization also notes that tobacco is a major risk factor for cardiovascular and respiratory diseases, cancer, and diabetes. Individuals with these pre-existing conditions are susceptible to developing more severe symptoms from COVID-19 infection. For example, those with cardiovascular diseases who become “ill with COVID-19 may suffer a heart attack or develop congestive heart failure.” This is likely due to a combination of increased strain on the heart, increased likelihood of low oxygen levels due to the onset of pneumonia, and increased chances of blood clots. Researchers at Penn State College of Medicine found (from a meta-analysis of 25 existing studies) that compared to “hospitalized COVID-19 patients without pre-existing conditions… patients with diabetes and cancer are 1.5 times more likely to die, patients with cardiovascular disease, hypertension, and congestive heart failure are twice as likely to die and patients with chronic kidney disease are three times more likely to die.”

Furthermore, the act of smoking could increase the risk of both spreading and catching the virus. Usually, smokers’ faces must be at least partially uncovered when they smoke, and they need to repeatedly touch their faces in the five-or-so minutes that it takes to smoke a cigarette. There is an ongoing debate about whether secondhand smoke from cigarettes and e-cigarettes transmits the virus. 

Addiction & Coping

A number of reasons may compel people to take up smoking. Unfortunately, a global pandemic that poses risks for serious illness or death, loss of income, social isolation, and/or uncertainty about the future might make smoking more attractive. According to the American Lung Association, inhaling nicotine contained in cigarettes and vapes triggers the release of dopamine, which provides a pleasant feeling. This pleasant feeling stays until the dopamine is depleted. Over time, the body needs more and more nicotine to achieve the same “buzz,” which leads to addiction. 

While the good feelings from smoking can help someone feel instant relief from stressors, it is not sustainable and greatly increases the chances of severe illness and morbidity during a pandemic. If you have never smoked before, or used to in the past and considering starting again—don’t start. If you currently smoke—make attempts to stop. 

If there has been a change in your “normal” daily routine due to the pandemic, Harpreet Gujral—program director of integrative medicine at Johns Hopkins’ Sibley Memorial Hospital—suggests coming up with a 15-minute ritual to get prepared for the day. This can include being physically active (e.g. yoga, repetitive prayer), practicing meditation, or doing breathing exercises—all of which are helpful ways to respond to stress. It might also be helpful to follow guided meditation or yoga sessions as you first practice. These small additions to your day can “make your body feel like it does when you are already relaxed.” Here is a short video on relaxing breathing exercises in Mongolian from the National Center for Mental Health. 

Similarly with smoking, living in a place with high levels of air pollution can make your lungs and respiratory systems more susceptible to severe COVID-19 illness. This is especially relevant for Mongolians in urban centers, as they currently breathe in unhealthy levels of air pollutants. To read more about steps you can take to protect yourself from air pollution and COVID-19, you can visit Breathe Mongolia’s web page for information in Mongolian and English

Ultimately, nicotine dependence is a medical problem. In order to improve your chances of quitting, please consult with a medical doctor. According to a study done by the University of Vermont, “[the] most important aspect to smoking cessation is maintaining the motivation to make multiple attempts.” To receive toll-free mental health support in Mongolia, you can reach the National Mental Health Hotline at (+976) 1800-2000. 



Edited by Amarjargal Dagvadorj

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