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Vol. 58. Issue 1.
Pages 104 (January 2022)
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Vol. 58. Issue 1.
Pages 104 (January 2022)
Letter to the Editor
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COVID-19 and Smoking: An Opportunity to Quit… When Vaccinated!
COVID-19 y fumar: una oportunidad para dejar de fumar… cuando se vacunan
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Marco Rossato
Corresponding author
marco.rossato@unipd.it

Corresponding author.
, Angelo Di Vincenzo, Roberto Vettor
Department of Medicine – DIMED, University Hospital of Padova, Padova, Italy
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To the Director:

We have read with interest the article by Pastor Esplà et al. and we agree with the authors that smoking is a risk factor for severe clinical course of COVID-19.1 To this respect we have also to consider that among patients hospitalized for SARS-CoV-2 related pneumonia, the prevalence of active smokers is very low, whatever the country we consider, from China to Europe and United States of America.2,3

There is a critical difference between the role of smoking (current/former) in the severe outcomes in COVID-19 and the quite low prevalence of active smokers among patients hospitalized for COVID-19. This is a very important issue since in the first case we all agree that smokers have more severe outcomes in COVID-19 probably due to the many comorbidities affecting smokers (active/former). In the second case, i.e. the low prevalence of current smokers among patients hospitalized for COVID-19, the main point is that current smoking seem to be “protective” towards the SARS-CoV-2 induced severe clinical complications.

To this respect there are data showing that among COVID-19 patients, significantly more former smokers were hospitalized and died from COVID-19 than current or never smokers.4 Thus there is the need to understand the possible mechanisms allowing cigarette smoking to dampen the inflammatory response during infection by SARS-CoV-2 strongly reducing the severe complications of SARS-CoV-2 infection, mainly interstitial pneumonia and ARDS.5

Thus, we fully agree with Pastor Esplà et al. in considering each occasion as a useful opportunity to quit smoking,1 thus reducing its well known unhealthy consequences. But considering the present SARS-CoV-2 pandemy, the lack of effective pharmacological treatments, and the reported ‘protective’ effects of active smoking towards severe COVID-19 complications, smoke cessation in current smokers could be suggested after SARS-CoV-2 vaccination!

References
[1]
E. Pastor Esplá, C. Castelló Faus, A. Jordá Baldó, I. Boira Enrique, E. Chiner Vives.
COVID-19 and smoking: an opportunity to quit.
Arch Bronconeumol, 57 (2021), pp. 784-785
[2]
M. Rossato, L. Russo, S. Mazzocut, A. Di Vincenzo, P. Fioretto, R. Vettor.
Current smoking is not associated with COVID-19.
Eur Respir J, 55 (2020), pp. 2001290
[3]
J. González-Rubio, C. Navarro-López, E. López-Nájera, A. López-Nájera, L. Jiménez-Díaz, J.D. Navarro-López, et al.
A systematic review and meta-analysis of hospitalised current smokers and COVID-19.
Int J Environ Res Public Health, 17 (2020), pp. 7394
[4]
D. Puebla Neira, A. Watts, J. Seashore, E. Polychronopoulou, Y.F. Kuo, G. Sharma.
Smoking and risk of COVID-19 hospitalization.
Respir Med, 182 (2021), pp. 106414
[5]
M. Rossato, A. Di Vincenzo.
Cigarette smoking and COVID-19.
Copyright © 2021. SEPAR
Archivos de Bronconeumología

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