Sars Cov-2 - Coronavirus 2019 - a virus that has defined a generation. The disease causes mild respiratory illness in most, with little or no need for treatment, but there are certain groups who are at risk of more severe symptoms.
Any respiratory illness impacts the lungs and airways, and we know that smoking tobacco products also negatively impacts the lungs and airways - therefore smoking is likely to increase the severity of symptoms of, and recovery from, respiratory infections.
With electronic cigarettes now being endorsed by the UK’s NHS, the value of vaping has been solidly established. Is there a difference between how smoking and vaping affect COVID-19?
WHAT IS THE IMPACT OF COVID-19 ON SMOKERS?
A study from Imperial College London published by the British Medical Journal examined data on almost two and a half million people, of which 11% were smokers, who self-reported their symptoms and test results between 24th March and 23rd April 2020. The study concludes that the data indicates those who smoke are at increased risk from symptomatic COVID-19 (1). The study demonstrated an increased risk of a higher number of symptoms for current smokers, with a 50% increased chance of suffering ten symptoms or more.
The World Health Organization assessed studies on the risk of outcomes for smokers versus non-smokers for COVID, and one meta analysis that included 7 studies and 1726 patients had results that indicate a statistically significant correlation between smoking and the severity of COVID outcomes (2), showing the risk factor for smokers of severe outcomes is 100% higher than in non-smokers.
The evidence on smokers and the risk of contracting COVID 19 is less clear.
There have been studies that indicate the risk of getting COVID is lower in smokers; one study examined the instances of COVID aboard a naval ship and found the current smokers had a 41% lower chance of becoming infected (3).
IS THERE A LINK BETWEEN VAPING VS SMOKING AND COVID-19?
Vaping and COVID 19 is problematic to explore, simply because there haven’t been many studies investigating vaping and COVID outcomes. The University College London conducted a study that looked into associations between vaping and self-reported diagnosis (or suspected diagnosis) and found no difference between never, current and ex-vapers and their self-reported COVID status (4).
However, a study published in the Journal of Adolescent Health used an online national survey of adolescents and young adults aged between 13 and 24 in May 2020 and found that a COVID-19 diagnosis was five times more likely among vapers, and seven times more likely in those that vape and smoke (5).
One of the key mechanisms at play appears to be that exposure to nicotine increases the expression (numbers) of ACE2 receptors in the lungs and airways in men - and it is this receptor that is used by the infamous ‘spike protein’ on coronavirus to gain entry to our cells. This suggests that particularly male smokers are at higher risk than female smokers of contracting COVID 19.
WHAT DO VAPES AND E-CIGARETTES CONTAIN?
Tobacco smoke contains several thousands of chemicals, of which over 50 are known to cause cancer. E-Cigarettes in comparison, have 3 main constituents, plus the option of nicotine - these constituents are propylene glycol (PG), vegetable glycerine (VG), and flavourings.
WHAT IS THE EFFECT OF VAPING ON THE BODY AND LUNGS?
Cigarette smoke is associated with many conditions, from lung disease to rheumatoid arthritis, and negatively impacts the cardiovascular system, our immune system, and our digestive system! Public Health England maintains that e-cigarettes are at least 95% less harmful than cigarettes and e cigarettes are going to be available soon via the NHS!
The main risks of smoking are increased likelihood of developing cancer, heart disease, stroke, lung diseases, diabetes and COPD (chronic obstructive pulmonary disease). Smoking impacts the immune system enough that the CDC considers tobacco smokers to be ‘immunocompromised’.
IS THERE SECOND HAND SMOKING VS SECOND HAND VAPING?
Second-hand smoke and second-hand vape aerosol are two very different beasts. The burning of tobacco creates many of the nasty chemicals that are then inhaled, and plenty of media articles indicate that many of these chemicals are also present in e-cigarette aerosol, citing this as the reason why vaping is not safe.
While this is true, the levels of these chemicals in e-cigarette are fractional compared to the levels found in tobacco smoke - one peer reviewed study demonstrated that many of the chemicals in vaping aerosol aren’t present in enough volume to be able to be quantified accurately (6).
Other chemicals in e-cigarette vapour were present in enough volume to measure; like acetaldehyde that was found at levels between 100 and 400 times smaller than those found in tobacco smoke, or acrolein that is present at 15 to 30 times smaller than the levels in tobacco smoke. It is worth noting two things in particular from the study - firstly, that the study was published in 2014 and vaping technology is improving with every passing year; and secondly, that only one brand of e-cigarette was used, and one tobacco flavour and one menthol flavour were analysed.
The study reports that the majority (approximately 85%) of damaging second hand smoke originates from the passive burning of the cigarette - something that is not present with e-cigarette use. Exhaled e-cigarette aerosol was also confirmed to be 99.9% water and vegetable glycerine, and the same study mentioned investigations that examined machine generated e-cigarette aerosol in closed spaces and found the levels of harmful chemicals did not exceed background levels - and that’s without passing through a pair of lungs!
WHAT ARE THE REASONS TO SWITCH TO VAPING?
Making the choice to smoke cigarettes or vape really is a simple one. The elimination of the many harmful chemicals in tobacco smoke is a major benefit to your cardiovascular system (among others) and if you are trying to quit tobacco then e-cigarettes, now endorsed by the UK’s National Health Service, could help you quit. One study found that people using e-cigarettes were almost twice as likely to quit smoking when accompanied by behavioural support.
When it comes to smoking and COVID-19, or other respiratory infections, your risk is increased. Smoking changes the structure of the respiratory tract and suppresses immune responses, and - as an example - increases the risk of pneumococcal disease by two to four times (7).
The Royal College of Physicians, UK, have stated that the evidence currently available suggests that e-cigarettes are being used almost exclusively as a less harmful alternative to tobacco (8), despite fears and suppositions that vaping is a pathway to smoking. The same institute also confirms that today’s quality of e-cigarette is unlikely to exceed 5% of the damage done from smoking.
Logically, therefore, vaping instead of smoking will reduce your risk of many diseases, not just respiratory infections like COVID.
IF I SMOKE, WHAT CAN I DO?
Quitting smoking is tough - make no mistake - there have never been better tools for quitting though! The forms of Nicotine Replacement Therapy offer a way to consume nicotine without all the harmful stuff you get with tobacco smoke, but vaping delivers the nicotine in an action familiar to smokers, which may contribute to the success of e-cigarettes as a stop smoking tool.
There are plenty of other ways to aid your quit smoking attempt, these include exercise, exposure to green spaces (nature, that is), mindfulness exercises, socialising, eating well and drinking lots of water!
- Exercise increases the metabolism, processing nicotine faster, and encourages sweating- a way for the body to excrete toxins.
- Spending time in green spaces has been linked to increased smoking cessation.
- Mindfulness exercises and socialising help to reduce stress, a primary trigger for smokers.
- Eating well is essential to wellbeing; smoker’s often have deficits (like vitamin C) due to the effects of nicotine.
- Drinking plenty of water is a must - staying hydrated means your body can easily get rid of toxins via urine and sweat.
Using an e-cigarette may be the answer to getting off the tobacco, so it is worth investigating. There are a few different types of vaping devices, from the ‘cigalike’ that looks like a cigarette, to ‘box mods’ that are chunky and high maintenance. Many quitters are looking for something small and convenient that works, with no messing, like the SMOKO E-Cigarette or the new SMOKO VAPE POD.
Making the switch to e-cigarettes today could help reduce your risk of catching and suffering severely from Coronavirus, a disease that experts believe to be endemic - that is to say, it will be with us for the foreseeable future.
So if you are an adult smoker and you are looking to kick the habit for good, why not try one of our most popular vape or e-cigarette starter kits!
REFERENCES
(1) Current smoking and COVID-19 risk
(2) World Health Organization: Smoking and COVID-19
(3) Impact of Tobacco Smoking on the Risk of Covid-19: A large scale retrospective cohort study
(4) Associations between vaping and Covid-19
(5) Association Between Youth Smoking, Electronic Cigarette Use, and COVID-19
(6) Comparison of Select Analytes in Exhaled Aerosol from E-Cigarettes with Exhaled Smoke from a Conventional Cigarette and Exhaled Breaths
(7) Cigarette smoking and infection
(8) Nicotine without smoke: Tobacco harm reduction
ABOUT THE AUTHOR
Written by Dan Overgage
Dan Overgage – is a former smoker of 10 years until he became a client of SMOKO E-Cigarettes. Dan started working with SMOKO 5 years ago after successfully quitting using our e-cigarettes and works across our Customer Service and heads up our content creation and research with a strong focus on all things quitting smoking. During his tenure with SMOKO, Dan has written countless blogs and consults with countless clients every day to help them to stay smoke-free.