New Delhi: The Union Ministry of Health and Family Welfare has refuted initial reports that nicotine or tobacco products can play a role in prevention or treatment of Covid-19, and warned that smokers are at a greater risk of being infected.
The ministry Tuesday released an advisory against tobacco use due to the Covid-19 pandemic, stressed that it increases the risk and severity of respiratory infections. The World Health Organization too had issued a statement on tobacco use being a risk factor for Covid-19 in May 2020.
The health ministry advisory comes almost three months after a non-peer-reviewed study from France claimed smokers are less likely to contract Covid-19.
India has over 27 crore tobacco users, and is its second highest producer and consumer in the world. Tobacco is responsible for over 3,500 deaths each day, and 1.28 lakh annually.
How smoking adds to Covid-19 risk
Smokers are more likely to be infected with Covid-19 because the act of smoking means that fingers are in contact with lips, which increases the possibility of the transmission of the virus from the hand to the mouth.
“Further, smoking products such as water pipes or hookah often involve the sharing of mouth-pieces and hoses, which could facilitate the transmission of Covid-19 in communal and social settings,” the health ministry advisory stated.
As Covid-19 is primarily a droplet infection, spread through saliva and discharge from the nose when the person sneezes or coughs, there is more risk for those consuming tobacco products to transmit the disease.
Chewing tobacco products like khaini, gutkha, paan and zarda increases the urge to spit, which in public places can increase the risk of spreading contagious diseases like Covid-19, as well as tuberculosis and swine flu.
As smoking affects the functioning of the lungs, smokers are more likely to die from Covid-19 or get a more severe form of the infection, the advisory said.
Tobacco use is a major risk factor for the four main non-communicable diseases —
cardiovascular disease, cancer, chronic lung disease and diabetes — which put people at higher risk for developing severe illness when affected by Covid-19. These diseases account for 63 per cent of all deaths in India, and these are expected to rise further, the ministry stated.
Smoking also suppresses immunity, making it difficult for the body to fight various diseases. Cigarettes contain over 69 cancer-causing chemicals, which suppress the immune cells, the advisory said.
Even products like e-cigarettes, smokeless tobacco, pan masala and the like increase the risk for severe lung infections, it added.
The advisory also mentioned the national tobacco cessation helpline, 1800-11-2356, and said the benefits of quitting smoking are experienced within hours. Just 12 hours after quitting it, the carbon monoxide level in the bloodstream goes down to normal, while in two to 12 weeks, circulation improves and lung function increases. After 1-9 weeks, coughing and shortness of breath decrease, the advisory said.
The French study that espoused nicotine
The non-peer-reviewed French study was published in April, suggesting that smoking makes people less likely to suffer from Covid-19 infection.
The French researchers had conducted an observational study on a limited number of outpatient and inpatients at a hospital, and found that 5.3 per cent of Covid-19 patients were smokers, compared to 25.4 per cent of the non-smoking population.
However, the health ministry advisory said: “The findings of these studies are inconsistent with the broader existing evidence that tobacco use impacts the lungs and other organs, lowers immunity and makes people vulnerable to Covid-19.”
The French study used limited data sets and the findings are inconclusive, added the advisory.
“Researchers of these studies do acknowledge the limitation in the study that hospitals were probably not recording patients’ smoking status properly as they were too busy treating patients,” it said.