Addiction & Recovery

Smoking Can Make COVID-19 Infections Worse


COVID-19 disproportionately affects the elderly, immunocompromised individuals, and those with underlying medical conditions. But there’s another group at high risk for this lung-infecting disease: tobacco smokers.

Smoking and vaping cause damage to the respiratory system, leaving smokers more susceptible to severe illness as coronavirus spreads. 

“The WHO and CDC have identified that smoking is a risk factor for getting ill with COVID-19,” said Rachel Smolowitz, PhD, Sheppard Pratt’s smoking cessation coordinator. “Smoking tobacco and vaping make it harder for the lungs to clean themselves as they normally would. It also makes the immune system weaker, so the virus can hit harder.”

Not only does smoking tobacco weaken the immune system and compromise lung function, it increases the likelihood of spreading the disease. SARS-CoV-2, the virus that causes COVID-19, is transmitted by touching the mouth or eyes after contacting a contaminated surface. Constant hand-to-mouth contact, like when smoking a cigarette or vaping a cartridge, introduces more infectious pathogens into the body and increases the chances for a virus to take hold.

How the body heals

The good news is that the healing process starts as soon as you quit smoking, and the risk of health problems continually decreases over time.

Cilia, the finger-like structures that line the airways and clear mucus from the lungs, are one of the first functions to recover after quitting smoking. Inhaling smoke slows down the movement of cilia, which makes it harder to clean the lungs and protect against infection.

“Your body's inclination to cough during an infection helps activate the bodily process of clearing out mucus,” according to CNN. “That's vital in fighting the COVID-19 condition.”

The immune system also sees improvement after quitting smoking. Inhaling tobacco smoke or vaping emissions inflames the airways and disrupts the body’s defense system. The less irritating substances you inhale, the less vulnerable your lungs are to infection.

“The presence of this inflammation in the face of an additional insult like SARS-CoV-2 makes it harder for our lungs to combat the invading virus and sets up the risk for many severe complications of the infection,” the American Lung Association explained. “Tobacco use has been proven to harm immune system and airway lining cells that contain cilia on their surface. which are our essential defenders against viruses.”

Quitting nicotine and breaking the habit

Quitting smoking is not easy, but it is essential in the fight against COVID-19 spread. Dr. Smolowitz identifies two main parts to the quitting process: managing the nicotine and managing the habit. Nicotine replacement therapy, like the patch, gum, lozenge, or a medication, puts the nicotine part on hold so that you can better understand the habit. It’s important to determine what exactly triggers the urge to smoke, what alternative activities you can do instead, and what helps you best manage stress in a healthy way.

“One of the most important parts of quitting smoking is remembering that it is necessary to add in a few healthy ways of enjoying yourself when you are taking out one habit on which you have relied,” she explained. “It is helpful to find those coping skills that work for you, as everyone’s are different.”

Some ideas for healthier coping strategies include:

  • Calming activities: listening to music or meditating
  • Physical activities: doing an online yoga class, running, or walking your dog
  • Social activities: joining a virtual 12-step meeting
  • Hobbies: crafting, caring for pets, or watching a YouTube video about fixing cars

If you’re thinking about quitting, learn more with Sheppard Pratt’s resources on smoking cessation and its benefits. The Maryland Quitline is also available for free phone counseling for quitting and free nicotine replacement at 1-800-QUIT-NOW.

  • Rachel Smolowitz, PhD

    Smoking Cessation Coordinator; Psychologist
    Co-Occurring Disorders, LGBTQ+ Mental Health Issues, Motivational Interviewing, Program Development, Psychotherapy, Smoking Cessation