Does Tobacco Use Enhance the Risk of SARS-CoV-2 Infection: Evidence from Eastern Indian Population

Document Type : Original Article

Authors

1 Department of Oral Medicine and Radiology, Dental Institute, Rajendra Institute of Medical Sciences (RIMS), Bariatu, Ranchi – 834009, India

2 Department of Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh - 160012, India

3 Department of Cardiothoracic and Vascular Surgery, Rajendra Institute of Medical Sciences (RIMS), Bariatu, Ranchi – 834009, India

4 Department of Pharmacology, Rajendra Institute of Medical Sciences (RIMS), Bariatu, Ranchi – 834009, India

10.34172/ahj.2023.1400

Abstract

Background: Tobacco consumption causes altered immune and inflammatory responses which lead to various respiratory 
diseases such as asthma and chronic obstructive pulmonary disease, as well as cardiovascular and cerebrovascular disorders. 
Studies have only confirmed the harmful effects of tobacco consumption on the severity of COVID-19. The present study aimed 
to explore the association between tobacco consumption and the initiation of COVID-19.
Methods: This retrospective cohort study was conducted to explore the relationship between tobacco consumption and 
COVID-19. A brief closed-ended, self-structured questionnaire was prepared to record participants’ responses. The Participants 
included the individuals who visited Rajendra Institute of Medical Sciences (RIMS), Ranchi, India for the COVID-19 diagnostic 
test. The statistical analysis was performed using SPSS software (version 24). The chi-square test and logistic regression analysis 
were also used to predict the odds of getting infected with COVID-19. 
Findings: A total of 521 valid responses were obtained and subjected to analysis. Moreover, 256 participants (49.13%) were 
COVID-19 positive and 57 participants (10.94%) were tobacco users. The odds ratio of tobacco consumption was higher in 
COVID-19-positive patients compared to COVID-19-negatives (OR=1.78; 95% CI 1.01, 3.13). The current tobacco users had 
a higher risk of developing COVID-19 as compared to the former users (OR=4.8; 95% CI 1.39, 16.61). The frequency and 
duration of tobacco use also affected the COVID-19 infectivity rate but these were statistically insignificant.
Conclusion: The COVID-19 positivity rate was significantly higher in tobacco users, especially in current tobacco users as 
compared to former users. Nevertheless, gender and occupation had no significant effect on COVID-19 incidence in this study.

Highlights

Arpita Rai: (Google Scholar) (PubMed)

Nishant Mehta: (Google Scholar) (PubMed)

Ansul Kumar: (Google Scholar) (PubMed)

Lakhan Majhee: (Google Scholar) (PubMed)

Pratik Verma: (Google Scholar) (PubMed)

Priyanka Singh: (Google Scholar) (PubMed)

Zeya Ul Haque: (Google Scholar) (PubMed)

Keywords

References

1. Gaunkar RB, Nagarsekar A, Carvalho KM, Jodalli PS, 
Mascarenhas K. COVID-19 in smokeless tobacco habitués: 
increased susceptibility and transmission. Cureus. 
2020;12(6):e8824. doi: 10.7759/cureus.8824.
2. Naik BN, Pandey S, Singh C, Nirala SK, Kumar P, Verma 
M. Pattern of tobacco use and perceived risk of COVID-19 
following tobacco use among the COVID-19 patients of a 
tertiary health care institution in Eastern India. Addict Health. 
2021;13(3):194-204. doi: 10.22122/ahj.v13i3.1262.
3. Kaur G, Yogeswaran S, Muthumalage T, Rahman I. 
Persistently increased systemic ACE2 activity is associated 
with an increased inflammatory response in smokers with 
COVID-19. Front Physiol. 2021;12:653045. doi: 10.3389/
fphys.2021.653045.
4. Emami A, Javanmardi F, Pirbonyeh N, Akbari A. Prevalence of 
underlying diseases in hospitalized patients with COVID-19: 
a systematic review and meta-analysis. Arch Acad Emerg 
Med. 2020;8(1):e35.
5. Simons D, Shahab L, Brown J, Perski O. The association of 
smoking status with SARS-CoV-2 infection, hospitalisation 
and mortality from COVID-19: a living rapid evidence review 
with Bayesian meta-analyses (version 12). Qeios [Preprint]. 
August 13, 2021. Available from: https://www.qeios.com/
read/UJR2AW.15.
6. Oakes JM, Fuchs RM, Gardner JD, Lazartigues E, Yue X. 
Nicotine and the renin-angiotensin system. Am J Physiol 
Regul Integr Comp Physiol. 2018;315(5):R895-R906. doi: 
10.1152/ajpregu.00099.2018.
7. Alla F, Berlin I, Nguyen-Thanh V, Guignard R, Pasquereau 
A, Quelet S, et al. Tobacco and COVID-19: a crisis within 
a crisis? Can J Public Health. 2020;111(6):995-9. doi: 
10.17269/s41997-020-00427-x.
8. Farsalinos K, Niaura R, Le Houezec J, Barbouni A, Tsatsakis 
A, Kouretas D, et al. Editorial: nicotine and SARS-CoV-2: 
COVID-19 may be a disease of the nicotinic cholinergic 
system. Toxicol Rep. 2020;7:658-63. doi: 10.1016/j.
toxrep.2020.04.012.
9. Sankhla B, Kachhwaha K, Hussain SY, Saxena S, Sireesha 
SK, Bhargava A. Genotoxic and carcinogenic effect of 
gutkha: a fast-growing smokeless tobacco. Addict Health. 
2018;10(1):52-63. doi: 10.22122/ahj.v10i1.537.
10. Patanavanich R, Glantz SA. Smoking is associated with 
COVID-19 progression: a meta-analysis. Nicotine Tob Res. 
2020;22(9):1653-6. doi: 10.1093/ntr/ntaa082.
11. Vardavas CI, Nikitara K. COVID-19 and smoking: a systematic 
review of the evidence. Tob Induc Dis. 2020;18:20. doi: 
10.18332/tid/119324.
12. WHO Statement: Tobacco Use and COVID-19. 2020. 
Available from: https://www.who.int/news/item/11-05-2020-
who-statement-tobacco-use-and-covid-19. Accessed June 20, 
2022.
13. Miyara M, Tubach F, Pourcher V, Morélot-Panzini C, Pernet J, 
Haroche J, et al. Lower rate of daily smokers with symptomatic 
COVID-19: a monocentric self-report of smoking habit 
study. Front Med (Lausanne). 2021;8:668995. doi: 10.3389/
fmed.2021.668995.
14. Beyerstedt S, Casaro EB, Rangel É B. COVID-19: angiotensinconverting enzyme 2 (ACE2) expression and tissue 
susceptibility to SARS-CoV-2 infection. Eur J Clin Microbiol 
Infect Dis. 2021;40(5):905-19. doi: 10.1007/s10096-020-
04138-6.
15. Vaduganathan M, Vardeny O, Michel T, McMurray JJV, 
Pfeffer MA, Solomon SD. Renin-angiotensin-aldosterone 
system inhibitors in patients with COVID-19. N Engl J Med. 
2020;382(17):1653-9. doi: 10.1056/NEJMsr2005760.
16. Paleiron N, Mayet A, Marbac V, Perisse A, Barazzutti H, 
Brocq FX, et al. Impact of tobacco smoking on the risk of 
COVID-19: a large scale retrospective cohort study. Nicotine 
Tob Res. 2021;23(8):1398-404. doi: 10.1093/ntr/ntab004.
17. Samet JM. Tobacco products and the risks of SARS-CoV-2 
infection and COVID-19. Nicotine Tob Res. 2020;22(12 
Suppl 2):S93-S5. doi: 10.1093/ntr/ntaa187.
18. Tindle HA, Newhouse PA, Freiberg MS. Beyond smoking 
cessation: investigating medicinal nicotine to prevent and 
treat COVID-19. Nicotine Tob Res. 2020;22(9):1669-70. doi: 
10.1093/ntr/ntaa077.
19. Boutou AK, Pitsiou G, Kontakiotis T, Kioumis I. Nicotine 
treatment and smoking cessation in the era of COVID-19 
pandemic: an interesting alliance. ERJ Open Res. 2020;6(3). 
doi: 10.1183/23120541.00306-2020.
20. Russo P, Bonassi S, Giacconi R, Malavolta M, Tomino 
C, Maggi F. COVID-19 and smoking: is nicotine the 
hidden link? Eur Respir J. 2020;55(6):2001116. doi: 
10.1183/13993003.01116-2020.
21. Sanchez-Ramirez DC, Mackey D. Underlying respiratory 
diseases, specifically COPD, and smoking are associated with 
severe COVID-19 outcomes: a systematic review and metaanalysis. Respir Med. 2020;171:106096. doi: 10.1016/j.
rmed.2020.106096.
22. Oelsner EC, Balte PP, Bhatt SP, Cassano PA, Couper D, 
Folsom AR, et al. Lung function decline in former smokers 
and low-intensity current smokers: a secondary data analysis 
of the NHLBI Pooled Cohorts Study. Lancet Respir Med. 
2020;8(1):34-44. doi: 10.1016/s2213-2600(19)30276-0.
Addiction & Health
Volume 15, Issue 3
July 2023
Pages 163-168

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