How Vaping May Raise Coronavirus Risk

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Vapers and cigarette smokers can have diminished lung capacity, making coronavirus infection especially dangerous.iStock (2)

The vast majority of people who develop serious complications from the novel coronavirus may already have an underlying health condition, such as lung disease or heart disease.

A preliminary investigation of 7,000 individuals with COVID-19 by the Centers for Disease Control and Prevention (CDC) shows that 78 percent of those admitted to intensive care and 94 percent of those who were hospitalized and died had at least one other significant health issue.

For those who vape — or smoke — this report should set off alarm bells.

“It would make sense that people who smoke have more serious complications [from coronavirus] because smoking is associated with virtually all the high-risk groups that have been identified for this infection in terms of hypertension, chronic lung disease, and cardiovascular disease,” says Enid Neptune, MD, an associate professor of medicine at Johns Hopkins Medicine in Baltimore.

As far as vaping is concerned, Robert Jackler, MD, a professor of otorhinolaryngology (ear, nose, and throat surgery) at Stanford University School of Medicine in Palo Alto, California, stresses that it may take some time to see evidence linking vaping to an increased risk of serious illness and death from COVID-19, “even though there is good, sound reason to think it is a risk factor,” he adds.

One Unhealthy Habit Rises as Another Falls

Dr. Jackler suggests that it’s difficult to understand vaping as a risk factor for COVID-19 complications simply because, compared with smoking, it’s relatively new.

E-cigarettes hit the market around 2003, as the Consumer Advocates for Smoke-Free Alternatives details. In just under two decades, they have climbed in popularity as tobacco smoking has waned.

Among adults in the United States ages 25 to 44, e-cigarette use almost doubled from 2012 to 2013 through 2018, rising from 2.4 percent to 4.2 percent, according to the public health organization Truth Initiative.

Meanwhile, cigarette smoking has declined. The CDC reports that the number of adults over 18 who smoke dropped from 20.9 percent (in 2005) to 15.5 percent (in 2016).

Truth Initiative estimates that just over half of current adult e-cigarette users also smoke regular cigarettes.

Even though e-cigarettes have a short history, researchers have conducted hundreds of studies on their health effects and found that they present many of the same hazards as smoking. A consensus study released in January 2018 by the National Academies of Science, Engineering, and Medicine reviewed more than 800 scientific investigations on the health consequences and concluded that e-cigarettes contain a number of toxic substances that may increase the risk of lung disease, heart disease, cancer, asthma, and other chronic illnesses.

On top of this, some vaping liquids containing THC (tetrahydrocannabinol, the compound responsible for the marijuana high) have been discovered to be laced with vitamin E acetate, a chemical additive linked to a recent national outbreak of a lung ailment known as EVALI. As of February 18, this vaping-related illness had led to more than 2,800 hospitalizations and 68 deaths in the United States, according to the CDC.

Vapers and cigarette smokers can have diminished lung capacity, making coronavirus infection especially dangerous.iStock (2)

The vast majority of people who develop serious complications from the novel coronavirus may already have an underlying health condition, such as lung disease or heart disease.

A preliminary investigation of 7,000 individuals with COVID-19 by the Centers for Disease Control and Prevention (CDC) shows that 78 percent of those admitted to intensive care and 94 percent of those who were hospitalized and died had at least one other significant health issue.

For those who vape — or smoke — this report should set off alarm bells.

“It would make sense that people who smoke have more serious complications [from coronavirus] because smoking is associated with virtually all the high-risk groups that have been identified for this infection in terms of hypertension, chronic lung disease, and cardiovascular disease,” says Enid Neptune, MD, an associate professor of medicine at Johns Hopkins Medicine in Baltimore.

As far as vaping is concerned, Robert Jackler, MD, a professor of otorhinolaryngology (ear, nose, and throat surgery) at Stanford University School of Medicine in Palo Alto, California, stresses that it may take some time to see evidence linking vaping to an increased risk of serious illness and death from COVID-19, “even though there is good, sound reason to think it is a risk factor,” he adds.

One Unhealthy Habit Rises as Another Falls

Dr. Jackler suggests that it’s difficult to understand vaping as a risk factor for COVID-19 complications simply because, compared with smoking, it’s relatively new.

E-cigarettes hit the market around 2003, as the Consumer Advocates for Smoke-Free Alternatives details. In just under two decades, they have climbed in popularity as tobacco smoking has waned.

Among adults in the United States ages 25 to 44, e-cigarette use almost doubled from 2012 to 2013 through 2018, rising from 2.4 percent to 4.2 percent, according to the public health organization Truth Initiative.

Meanwhile, cigarette smoking has declined. The CDC reports that the number of adults over 18 who smoke dropped from 20.9 percent (in 2005) to 15.5 percent (in 2016).

Truth Initiative estimates that just over half of current adult e-cigarette users also smoke regular cigarettes.

Even though e-cigarettes have a short history, researchers have conducted hundreds of studies on their health effects and found that they present many of the same hazards as smoking. A consensus study released in January 2018 by the National Academies of Science, Engineering, and Medicine reviewed more than 800 scientific investigations on the health consequences and concluded that e-cigarettes contain a number of toxic substances that may increase the risk of lung disease, heart disease, cancer, asthma, and other chronic illnesses.

On top of this, some vaping liquids containing THC (tetrahydrocannabinol, the compound responsible for the marijuana high) have been discovered to be laced with vitamin E acetate, a chemical additive linked to a recent national outbreak of a lung ailment known as EVALI. As of February 18, this vaping-related illness had led to more than 2,800 hospitalizations and 68 deaths in the United States, according to the CDC.

The Lungs May Be Critically Compromised

Scientific study on whether vaping and smoking raise the risk of COVID-19 complications is just beginning. One investigation of 78 people with COVID-19, published online on February 28 in the Chinese Medical Journal, found that those with a history of smoking were 14 times as likely to develop pneumonia. So far, investigations on vaping and the virus have been even more scarce.

Still, Stanton Glantz, PhD, the director of the Center for Tobacco Control Research and Education at the University of California, San Francisco, writes that “reporting of respiratory symptoms by e-cigarette users suggests increased susceptibility to and/or delayed recovery from respiratory infections.”

Len Horovitz, MD, a pulmonary specialist at Lenox Hill Hospital in New York City, adds, “It’s already been clear with vaping that there’s an inflammatory response of the lung, so adding coronavirus to vaping could be disastrous.”

Dr. Horovitz explains that vaping and smoking impair or kill off cilia, hairlike projections on cells in the airway that help clear the body of particulate matter and infectious agents.

Vapers and smokers can have diminished lung capacity, and if the virus strikes, that can prove to be deadly.

“When you get COVID and it begins to cause interstitial pneumonia, it leads to a swelling between the air sacs and it diminishes the oxygen uptake efficiency by the lung,” says Jackler. “Now if you’re a person who has 100 percent normal lung function and it is cut down by half, you can probably handle it with supplemental oxygen. But if you are a long-term smoker or vaper and have only 60 percent vital capacity in the lungs, if you cut that in half, you’re in very serious trouble.”

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