Studies indicate that smoking may increase a person’s chances of contracting the SARS-CoV-2 virus that causes COVID-19. They also suggest that smoking may worsen COVID-19 symptoms and increase the likelihood of COVID-19 complications.

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Medical professionals recommend quitting smoking to reduce the risk of infections and diseases and improve overall health.

This article examines the link between smoking and COVID-19 and answers some frequently asked questions about the association. It also offers tips for quitting smoking.

Coronavirus data

All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our coronavirus hub for the most recent information on COVID-19.

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Below are some factors that influence the association between smoking and COVID-19.

Hygiene concerns

The World Health Organization (WHO) notes that people who smoke are likely to have greater exposure to the SARS-CoV-2 virus that causes COVID-19. This may be due to the following:

  • increased rate of hand-to-mouth contact
  • sharing of cigarettes and smoking devices
  • increased incidence of mouth breathing, which reduces the filtration of microorganisms in the upper respiratory system

Reduced immunity

The Centers for Disease Control and Prevention (CDC) note that smoking affects immunity, making people more susceptible to infections.

A 2022 study highlights the association between smoking and increased rates of infection. The study reanalyzed data from between 1986 and 1989, where researchers exposed 399 healthy adults to 1 of 5 common cold viruses. The reanalysis found that participants who smoked had a 12% increase in the risk of having a laboratory-confirmed infection compared with people who did not smoke.

Respiratory damage

According to the CDC, smoking damages tiny air sacs called “alveoli” within the lungs. These air sacs are responsible for exchanging oxygen and carbon dioxide during breathing. Destruction of the alveoli affects breathing and increases the risk of respiratory diseases, including chronic obstructive pulmonary disease (COPD).

In line with this, a 2022 study found that people with COPD have worse COVID-19 outcomes compared to those who do not have COPD. This may be because people with COPD experience repeated lung infections and are more susceptible to viruses entering the lungs.

As the WHO notes, COVID-19 primarily attacks the lungs and other parts of the respiratory system. As such, lungs that are already compromised by smoking may be more susceptible to the effects of COVID-19.

Read more about COVID-19.

A 2021 review examined the association between smoking and the risk of COVID-19. The study authors note that the relationship between smoking and COVID-19 is a complicated one.

The study found that smoking:

  • increases the chance of the SARS-CoV-2 virus entering the body
  • aids the progression of COVID-19
  • worsens symptoms of COVID-19

The study authors note that while smokers are more susceptible to COVID-19, the nicotine compound in smoke may inhibit the growth of SARS-CoV-2. Nonetheless, they point out that smoking increases the risk of diseases that can worsen the outlook for COVID-19, including:

As such, smoking has an overall detrimental effect on COVID-19 outcomes.

According to the British Heart Foundation (BHF), quitting smoking is the most important step a person can take to improve their health.

The BHF notes that a person may experience easier breathing within the first few days of quitting smoking and improved blood flow within the first few weeks.

Other benefits of quitting smoking include the following:

  • reduced incidence and severity of lung infections
  • reduced risk of smoking-related respiratory conditions
  • reduced risk of cardiovascular diseases, such as stroke and heart attack

People can also reduce their risk of contracting the SARS-CoV-2 virus, leading to severe COVID-19. The CDC provides the following tips for preventing the spread of COVID-19:

  • washing hands regularly with soap and water or regularly applying hand sanitizer containing at least 60% alcohol
  • avoiding touching the face with unwashed hands
  • avoiding close contact with others and staying 6 feet away from anyone who is coughing and sneezing
  • covering the mouth and nose when coughing and sneezing
  • staying home if unwell

The United Kingdom’s National Health Service (NHS) recommends that people who are trying to quit smoking consider:

  • speaking with a doctor or other healthcare professional about quitting
  • telling others of their intention to quit
  • building a support system of friends or family members who have successfully quit smoking
  • joining online support groups
  • listing and avoiding triggers for smoking
  • avoiding being around other people who smoke
  • throwing away all cigarettes, ashtrays, and other smoking paraphernalia
  • considering nicotine replacement therapy (NRT), such as gums, patches, and inhalers
  • exercising or keeping busy to keep cravings at bay

Below are some answers to frequently asked questions about smoking and COVID-19.

Does smoking make COVID-19 worse?

A 2022 study used data from the American Heart Association’s Get With The Guidelines COVID-19 registry to investigate the relationship between smoking and the following factors:

  • cardiovascular events
  • COVID-19 severity
  • COVID-19 mortality

Using the registry, the researchers analyzed data from 6,717 people admitted to the hospital with COVID-19 in 2019. They matched participant groups according to the following factors:

  • age
  • sex
  • medical history
  • medications
  • length of hospital stay

The findings suggest that adults who smoked were significantly more likely to experience severe COVID-19 complications compared with those who did not smoke. Specifically, adults who smoked had a 15% higher risk of requiring mechanical ventilation aids and a 41% greater risk of death.

Does smoking slow down COVID-19 recovery?

A 2021 report showed that current smokers were 80% more likely to be admitted to the hospital and were significantly more likely to die from COVID-19. This suggests that smoking may worsen COVID-19 symptoms and recovery.

According to a 2022 study, smoking increases the risk of post-acute COVID-19 syndrome. This is the medical term for COVID-19 symptoms or complications that develop or persist 4 weeks after the initial onset of symptoms.

A 2021 study investigated the association between cumulative smoking and COVID-19 outcomes. The study authors defined cumulative smoking as the number of years a person has smoked during their lifetime, regardless of whether they are a past or current smoker.

The researchers compared cumulative smokers with people who had never smoked (never-smokers). Their results suggest the following:

  • Compared with never-smokers, people who had smoked for over 30 years were 2.25 times more likely to go to the hospital with COVID-19.
  • Compared with never-smokers, people who had smoked for more than 30 years were 1.89 times more likely to die following a diagnosis of COVID-19.

The study authors suggested that the association between cumulative smoking and more negative COVID-19 outcomes is likely due to the detrimental effect smoking has on overall health.

COVID-19 is an infectious disease caused by the SARS-CoV-2 virus. The disease primarily attacks the respiratory system.

Smoking has numerous detrimental effects on health, including the health of the respiratory and immune systems. Recent research suggests that smoking increases the likelihood of exposure to the SARS-CoV-2 virus and links to an increase in the risk of COVID-19 severity and complications.

People who want to quit smoking can talk with their doctor or pharmacist for information and advice. Some helpful methods for quitting include joining a support group, identifying and avoiding smoking triggers, and trying nicotine replacement therapy.