Smoking and coronavirus are a catastrophic combination, says foundation.

Brazil Agency - The executive director of the Cancer Foundation, Luiz Augusto Maltoni, said that, since smoking is a risk factor for respiratory infections, vascular, cardiovascular and pulmonary diseases, and the new coronavirus has its main entry point there, the "combination is catastrophic".

An analysis published in China, comparing the first cases of COVID-19 between groups of smokers and non-smokers, showed that the disease had a more severe progression and a higher mortality rate in the group of smokers. "Some articles showed 1,5 times more, others 2,4 times more. In other words, you more than double the chance of the disease becoming severe and double the deaths compared to the group that does not smoke."

Dissemination

Maltoni drew attention to the fact that the virus spreads easily, mainly through contamination via droplets (contaminated droplets of saliva). Another aggravating factor in relation to smoking is the use of hookah (a type of water pipe of oriental origin, used to smoke flavored tobacco and, occasionally, marijuana or opium) worldwide.

“It is a very high mechanism for spreading the virus, to the point that countries like Iran have banned its use in bars and streets due to the possibility of propagation, because it passes from mouth to mouth. It is also a very dangerous association,” he highlighted. According to Maltoni, there is a very strong relationship between smoking and the worsening of the conditions of patients who become infected with the new coronavirus, with a greater increase in lethality.

The same problem occurs with electronic cigarettes (also called vapes, they are electronic smoking devices powered by lithium batteries). "They are another way of dispersing nicotine and other products into the human body."

Although the tobacco industry claims it is a tool to help people quit smoking, the executive director of the Cancer Foundation stated that this type of cigarette contains toxic substances, including nicotine, which is offered in liquid form and forms an aerosol.

"This inhalation of nicotine reaches the bloodstream even faster than conventional cigarettes." Maltoni highlighted that nicotine is the main cause of addiction, with all the harmful effects on the body, such as altering cellular immunity at the pulmonary level, altering the DNA of lung cells, predisposing them to the transformation of cells into cancer, into tumors. This is also present in electronic cigarettes.

WHO alert

On the 11th of this month, the World Health Organization (WHO) issued a public statement warning that tobacco kills more than 8 million people worldwide each year. More than 7 million of these deaths are due to direct tobacco use, and approximately 1,2 million are due to non-smokers being exposed to secondhand smoke.

A group of public health experts, invited by the WHO, analyzed previously published studies on COVID-19 and its relationship with smoking. They found that smokers were more likely to develop severe illness and complications from the infection compared to non-smokers, "including a higher proportion of deaths than the non-smoking group," Maltoni noted.

Nicotine and COVID-19

The WHO has also positioned itself against studies favoring the adoption of substances such as nicotine in the treatment of patients with COVID-19. Although without specifically referring to a French study that defends nicotine as protection against COVID-19, the organization warns that caution is needed when adopting this type of recommendation, before tests are carried out and their results confirmed by internationally credible institutions.

Luiz Augusto Maltoni pointed out that, in the case of the French study, it was published on the internet and not in a reputable scientific journal, as is traditionally done, where an editorial committee scientifically analyzes whether the study's methodology was well-conducted before authorizing its publication. The study was not peer-reviewed and makes no reference to approval by any research ethics committee, Maltoni stated.

The executive director of the Cancer Foundation described the study as "a huge mistake." One of the authors is a researcher who, for a long time, was funded by the tobacco industry, he said. From a scientific point of view, the work deserves neither credit nor citation, Maltoni added.

Joint note

Based on the French research, seven medical entities, including the Cancer Foundation, the Brazilian Medical Association, the Brazilian Association for the Study of Alcohol and Other Drugs, and the Brazilian Society of Pulmonology and Phthisiology, released a statement in which they believe that "it is too early and risky" to claim that there is any potential protective factor of nicotine against COVID-19. "Once infected with the new coronavirus, smokers tend to have a worse prognosis, with more severe illness and deaths," the statement says.

Health organizations are reinforcing the importance of combating smoking. A study by the National Cancer Institute showed that the country spends approximately R$ 57 billion per year on medical expenses and lost productivity related to smoking-related illnesses. The study also shows that the country collects R$ 13 billion in taxes annually from the tobacco industry, meaning there is a shortfall of at least R$ 44 billion for the Brazilian healthcare system. Every day, 428 people die due to smoking in Brazil.