COVID-19 and Smoking

  • 1st Revision: Francesca Fitzgerald
  • 2nd Revision: Was Karim
  • 3rd Revision: Ha Nguyen

There is a possibility that people who smoke or vape are more likely to get seriously sick from COVID-19. Therefore, it is even more important for people who smoke to take steps to protect themselves from the new coronavirus. According to WHO (World Health Organisation), there is a statistically significant relationship between smoking and the severity of COVID-19 outcomes amongst patients.

Are smokers more likely to get COVID-19?

In the process of smoking or vaping, one’s fingers touch their lips, which increases the chance of spreading the virus from the hand to the mouth. Also, if a person uses a smoking product such as a water pipe, it is more likely they will share their mouthpieces or hoses with others. If they are shared with someone infected, one can get infected with the virus as well.

Smoking and vaping can lower your immunity to respiratory infections. Research has shown that e-cigarettes can suppress the immune cells present in the nose1.

Cilia (tiny, hair-like structures that trap viruses and debris and sweep them out of the airways) present in the lungs can also be destroyed. Cilia are one of the main defences against infection present in the body. Viruses can easily settle into the lungs if they get damaged.

How does COVID-19 get into the lungs?

Lungs have ACE2 receptors, which are a type of receptor protein on the surface of many cells. COVID-19 can enter the cells of the lungs by binding to these receptors. Researchers found that ACE2 levels increase with cigarette smoking, although it is not yet clear exactly what effect this may have on your chances of contracting COVID-192.

Are smokers at higher risk of severe COVID-19 infections?

People who smoke generally have more lung problems. They are therefore more vulnerable to COVID-19. Smokers are at a higher risk of developing more severe symptoms when they have the flu or another lung infection in comparison to non-smokers.

This is because, as a result of smoking, one’s lungs get damaged and do not provide enough oxygen nor utilise the oxygen already present in the lungs in a proper manner. Also, if cilia get destroyed, it is much harder for the lungs to clear out any mucus.

People who smoke are more vulnerable to lung conditions such as pneumonia and are even at a higher risk of complications like ARDS (Acute Respiratory Distress Syndrome). This is a condition in which not enough air can fill the lungs because of water retention in tiny air sacs in the lungs.

This means that less oxygen gets to your bloodstream and organs, which can lead to organ failure or even death. A study conducted on COVID-19 patients with pneumonia in a hospital found that the disease was 14 times more likely to worsen for those with a history of smoking. 

Smoking can also lead to more serious complications such as COPD (Chronic Obstructive Pulmonary Disease), and blood vessel and heart disorders. 

Source: Jaber et al., (2021)3

Is the Covid-19 pandemic the right time to stop smoking?

Quitting smoking is even more important during the Covid-19 pandemic. Some of the benefits of quitting smoking are listed below.

What happens to smokers once they quit?

Within 24 hours

The risk of a heart attack reduces within 24 hours as the blood vessels that were constricted due to smoking start to loosen up. The levels of carbon monoxide in the blood reduce and blood oxygen levels, blood pressure, and heart rate come back to normal. 

Within 72 hours

Damaged nerve cells will begin to heal. This is generally the hardest time for nicotine cravings but these start to decrease as the nicotine receptors in your brain begin to adapt to lack of nicotine.

Within one month

The cravings become easier to manage after one month of quitting smoking. The risk of vision damage and hearing loss decreases. Skin starts to heal from premature ageing and wrinkling, and teeth become whiter.

You might also find that it is easier to walk up the stairs as the lungs repair themselves and the risk of having a heart attack or stroke also diminishes. Cilia in the respiratory tract are one of the first things to heal in the body. Additionally, you might notice that you aren’t getting sick as often as healthy cilia help you fight off bacteria and viruses.

After one year

The risk of contracting coronary heart diseases drops to half that of current smokers, and your lungs will function at a near-normal level. Some of the DNA damage caused by smoking even begins to heal. 

After 15 years without smoking, your risk of stroke, lung cancer, and heart disease will be about the same as those of people who never smoked.


  1. Alqahtani, J.S., Aldhahir, A.M., Oyelade, T., Alghamdi, S.M. and Almamary, A.S. (2021). Smoking cessation during COVID-19: the top to-do list. npj Primary Care Respiratory Medicine, 31(1).
  2. WebMD. (n.d.). Coronavirus and Smoking. [online] Available at: [Accessed 30 Sep. 2021].
  3. (2020). Smoking and COVID-19. [online] Available at:
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

Get our health newsletter

Get daily health and wellness advice from our medical team.
Your privacy is important to us. Any information you provide to this website may be placed by us on our servers. If you do not agree do not provide the information.

Anjula Gahlot

Master of Science, Global Public Health and Policy, Queen Mary University of London

Activities and societies: Elected as IFMSA Subcommittee member, Students for Global Health Society, Barts and the London School of Medicine and Dentistry; Active Member of St. Johns Ambulance Society.

Leave a Reply

Your email address will not be published. Required fields are marked * presents all health information in line with our terms and conditions. It is essential to understand that the medical information available on our platform is not intended to substitute the relationship between a patient and their physician or doctor, as well as any medical guidance they offer. Always consult with a healthcare professional before making any decisions based on the information found on our website.
Klarity is a citizen-centric health data management platform that enables citizens to securely access, control and share their own health data. Klarity Health Library aims to provide clear and evidence-based health and wellness related informative articles. 
Klarity / Managed Self Ltd
Alum House
5 Alum Chine Road
Westbourne Bournemouth BH4 8DT
VAT Number: 362 5758 74
Company Number: 10696687

Phone Number:

 +44 20 3239 9818