Smoking, Vaping, and COVID-19 Emerging Evidence

Smokers and
vapers may be
at greater risk
for severe illness
confronted with
Smoking Harms Lung Health
Smoking damages the lungs and negatively impacts
how well they function.
• The lungs of smokers produce more and thicker mucus
than the lungs of nonsmokers. This mucus is both difficult to remove and makes the lungs prone to infection.1
• Smoking also inhibits and eventually destroys the cilia,
the small hair-like projections on the surfaces of cells
in the breathing airway that brush away dirt and other
particles to protect the lungs.2
• Exposure to cigarette smoke causes airway
inflammation. This inflammation and the resulting scar
tissue damage the membranes that pass oxygen to the
Smoking causes lung cancer, chronic obstructed
pulmonary disease (COPD), asthma, and other
respiratory diseases.
• The lung diseases caused by smoking occur among
smokers and non-smokers exposed to tobacco smoke.1
• The lung diseases caused by smoking are among
the underlying conditions known to place people at
greater risk of more severe illness when diagnosed
with COVID-19.3,4
Smoking Impairs Immunity
Smoking harms the immune system and, therefore,
the body’s ability to fight infection. This impairment
occurs in two different ways.
• The chemicals in tobacco smoke suppress the activity
of different types of immune cells that are involved in
general and targeted immune responses.1
• The components in tobacco smoke also over-activate immune cells, which are recruited to combat the
toxins that are inhaled and their effects. Over time, this
pro-inflammatory effect can damage different tissues
throughout the body and result in a number of chronic diseases including various autoimmune diseases,
cardiovascular disease, cancer, diabetes, and chronic
obstructive pulmonary disease (COPD.)1,5
Smoking increases susceptibility to respiratory
• There is overwhelming evidence that people who
smoke are at higher risk of getting viral and bacterial
respiratory infections:
o Smokers have two to four times the risk of pneumococcal diseases like pneumonia and meningitis than
o Influenza risk is twice as high in smokers compared
with nonsmokers.
o Smokers have about twice the risk of contracting
In light of smoking’s negative impacts on the immune
system and smokers’ increased susceptibility to other
respiratory infections, it is likely that smoking is associated
with increased risk of infection with the novel coronavirus.
Smoking, Vaping, and COVID-19
Emerging Evidence
• COVID-19 attacks the lungs and behaviors that weaken the lungs put individuals at greater
risk. The harmful impact of smoking on the lungs is well-documented, and there is evidence
that e-cigarette use (vaping) can also harm lung health.
• It is not surprising that there is mounting concern among leading public health
organizations and experts that smokers face a higher risk for severe illness from COVID-19.
As vaping impacts the immune system and can harm lung health, e-cigarette users may also
face higher risks. We urge all smokers and e-cigarette users to quit in order to protect their
health, especially at this critical time.
• In several countries, rumors have been spread that smoking or vaping will protect tobacco
users from COVID-19. These are unproven and dangerous. Tobacco kills over 8 million users
each year and its harms are scientifically proven