Coronavirus Attacks the Lungs. Here's What That Means for Smokers and Vapers

As cases of the new coronavirus, aka COVID-19, continue to appear in more U.S. states and lead to more deaths, it’s easy to feel overwhelmed by the whole situation. While, no, you shouldn’t be panicking—it’s not time to start avoiding public transportation, and unless you’re a healthcare provider on the front lines, you shouldn’t even be buying masks—it’s reasonable to want to know what is going on.

If you’re someone who smokes or vapes, meaning your lung health is likely compromised, you may be wondering how that plays into what looks like an emerging global pandemic of lung infections. Reports have suggested that Chinese men make up slightly more than half the diagnosed cases, leading to speculation that in China—where more than half of men smoke, compared to less than 2 percent of women—smoking may be a factor in rates of infection and death.

As Russell Buhr, a pulmonologist at UCLA Health, pointed out, the largest study to come out of China, which collated records from 72,314 patients, did show more men were infected than women, but it didn’t break down who smoked and who didn't. It’s possible that men are more susceptible to the virus for reasons entirely other than their greater rates of smoking—but we don’t know that yet.

Here's what smokers and vapers need to know.

Maybe—we don't know. “We know that exposure to tobacco and tobacco products impairs our body’s ability to fight off infection,” Buhr said. That’s established science. (And, if you need it, a reason to quit smoking.) Generally speaking, smokers’ lungs specifically have a harder time responding effectively to infection. Long-term smoking can lead to chronic obstructive pulmonary disease (COPD), a condition that also makes people more susceptible to infection.

So what about COVID-19? “In general we know a lot about coronaviruses, they’re in the same category that causes the common cold,” Buhr said. But this is a new coronavirus; researchers are still figuring out how it works, and learning who may be more susceptible. So far, the general attributes of this category seem to be consistent over time and place: Kids have almost no risk of dying from the infection, while older people tend to be more at risk. Chronic diseases such as diabetes and high blood pressure tend to make the infection worse. This, according to Buhr, is all pretty familiar for this kind of virus.

That said, so far we just don’t know whether smokers may be more susceptible specifically to COVID-19, beyond what we know about how smoking impairs your ability to avoid infection generally. “Anytime the lung is compromised, it makes it easier to get infected and the person has a harder time recovering,” said Yasmin Thanavala, a professor in the Roswell Park Comprehensive Cancer Center’s Department of Immunology in Buffalo, New York.

A condition like COPD, for example, increases the likelihood of infections generally—but Thanavala points out that we’re still learning just what happens in the lungs of coronavirus patients. “We don’t know if anyone had COPD and coronavirus at the same time,” she said.So far, so-called comorbid factors or conditions that patients had alongside COVID-19—including cardiovascular disease, diabetes, chronic respiratory disease, hypertension, and cancer—do correlate with higher rates of death among those infected. But we don’t specifically know if smokers get hit harder.

Thanavala studies the effects of vaping; she and her colleagues recently suggested through research that Vitamin E acetate caused lung damage in vapers. She points out that in mice, smoke and second-hand smoke cause inflammation and suppress immune response. And while the data is still emerging, she said that in preclinical studies in mice, “regular vaping does alter the ability of the animal to respond to infection.” Again, we’re talking about lungs being generally compromised, apart from any specific vulnerabilities to COVID-19. But, she said, “It would not be a far stretch to say that vaping in general, and vaping with THC may compromise the ability of the lungs to deal with infection.”

Short answer: not anything that differs from everyone else. In the absence of a vaccine or directed treatment, prevention is your best defense. That means washing your hands and not touching your face, and coughing into your elbow, among other basic steps. And trust the experts. “We want people to take this seriously,” Buhr said. “So people should really be listening to their doctors.”

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