Dr. Nora D. Volkow, director of the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health. Dr. Volkow says COVID-19 poses unique challenges to people who smoke or vape.

Her report in the Annals of Internal Medicine say the risk for severe COVID-19 and death escalates with older age but is also concentrated among those who are immunocompromised or have underlying health conditions, including diabetes, cancer, and heart and respiratory diseases. Many of the latter arise from smoking and thus may increase risk for death and illness among smokers (tobacco or cannabis).

Volkow also addresses the risk to those who have substance abuse issues.

The Journal of the American Medical Association (JAMA) has reported that data from the Chinese Center for Disease Control and Prevention have suggested that COVID-19 has a case fatality rate of 6.3% for individuals with chronic respiratory disease, compared with 2.3% overall

Volkow says “persons whose lungs may be compromised from vaping nicotine or tetrahydrocannabinol (or even just flavorings) may also be at risk. The highly publicized lung illnesses from vaping, including “popcorn lung” and e-cigarette or vaping product use–associated lung injury, alert us to the potential for lung injury from vaping, which is on the rise especially in young persons. Preclinical studies show that e-cigarette aerosols can damage lung tissue, cause inflammation, and diminish the lungs’ ability to respond to infection.”

The Hawaii State Department of Health addressed the dangers from vaping in October, 2019, and gave the advice for people to stop vaping (as well as smoking).  That was well before the COVID-19 outbreak.

However, some researchers in France believe that nicotine can actually protect people from COVID-19.  They looked at approximately 11,000  patients hospitalized in Paris public hospitals for Covid-19 at the start of April, and found that only 8.5 percent were smokers, compared to 25.4 percent of the general public.   According to a  paper posted at Qeios, which uses an Open Post-Publication Peer Review model, researchers are exploring giving nicotine patches to people in a study to see if nicotine makes a difference in the rate of infection of COVID-19.   At the same time, the researchers said they were not encouraging people to take up smoking–which has considerable risks–and numerous publications report that the French Health Ministry is now limiting the sales of nicotine patches.

Medscape News, in reporting on the matter, says “There are many clinical trials testing various treatments for COVID-19, and the beginning of a trial is not as relevant for busy clinicians as the results. This clinical trial’s results could be informative, but the hospital data is not itself enough to change treatment protocols.”