Smokers appear to be at higher risk from coronavirus – expert

Dr. Yael Bar-Zeev says that while system copes with 8,000 yearly deaths from smoking, special steps needed to stop it collapsing if thousands of COVID-19 cases emerge at once

Sue Surkes is The Times of Israel's environment reporter

Illustrative photo of people smoking cigarettes. (Nati Shohat/Flash90)
Illustrative photo of people smoking cigarettes. (Nati Shohat/Flash90)

Smokers appear to be at higher risk from the coronavirus than nonsmokers, Dr. Yael Bar-Zeev, chair of the Israeli Medical Association for Smoking Cessation and Prevention, said Sunday.

Addressing smokers on Camoni (Like Me), an online site providing group support for people with a variety of chronic illnesses as well as those wishing to stop smoking, Bar-Zeev, a public health physician at Hebrew University’s Braun School of Public Health and Community Health, wrote, “Here’s what we already know: In a small study of about 80 corona patients, those who smoked were 14 times more likely to have serious illness.

“In China, mortality rates were higher in men than women. One of the hypotheses is that this was also due to smoking. About 50 percent of men in China smoke, compared to only 2% of women.

“Smoking causes many already known background diseases that raise the risk of serious morbidity [illness] and mortality from corona — chronic obstructive pulmonary disease, heart disease, and diabetes.

Dr Yael Bar-Zeev, chair of the Israeli Medical Association for Smoking Cessation and Prevention and a public health physician at Hebrew University’s Braun School of Public Health and Community Health. (Courtesy)

“Many times, people get sick with these diseases in the early years and do not know that they are sick because the disease is still at an initial stage.

She continued, “Smoking weakens the immune system in general, and increases the risk of getting viruses and bacteria in the respiratory system. Smokers are likely to have a greater risk of corona disease and a more severe morbidity and mortality risk.”

One of Israel’s few coronavirus patients to be listed as serious is a 38-year-old man who was exposed to the virus while driving a group of Greek tourists. According to reports, the severity of his condition — unusual for a man of his age — was linked by doctors to the fact that he is a smoker.

Bar-Zeev noted that “the coming period is accompanied by many uncertainties and concerns, which naturally increase our nervousness and may lead to an increased need for smoking in some people. It is important to prepare for this, and to plan ahead… On the one hand, this information [about the dangers of smoking and coronavirus] is stressful. On the other hand, it also allows you to act. If up to now, you’ve been dithering or thinking about quitting, now is the time to try.”

Speaking to The Times of Israel, Bar-Zeev emphasized that research about coronavirus is still in its infancy, with studies based either on data from China or on small tests from hospitals elsewhere where data has been analyzed quickly. “It’s supposition at the moment. It’s not research-based. We don’t yet know how the disease works,” she said. “But there’s lots of physiological logic that smoking causes extra danger because it weakens the immune system and it harms the organs that we know make us more susceptible to serious illness.”

Asked whether the authorities should not have taken more drastic action to protect the population from smoking, air pollution and other factors that weaken the immune system and make people more vulnerable to the danger of epidemics and pandemics when they arise, Bar-Zeev said that it was not right to compare the two.

Pollution seen from an unrecognized Bedouin village close to the Ramat Hovav industrial zone in southern Israel, December 28, 2017. (Yaniv Nadav/FLASH90)

The system can deal with the 8,000 Israelis who die annually from smoking-related diseases, but could collapse if thousands of people were infected with COVID-19 within a very short time.

“Smoking, air pollution, and an environment that encourages obesity are long-term problems that the system is addressing daily, although it could always do more. If we were talking about the flu, the response would be different.

“Coronovirus, by contrast, has the potential to infect thousands of people within a very short time, which is something that the system will be unable to deal with unless steps are taken now.

“The difference is in how the system deals with things,” she said.

According to the Health Ministry’s most recent annual report to the Knesset on smoking, covering 2018 and published last year, around one in five Israelis smokes — nearly 25% of men and 15% of women.

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