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Latest on smoking and Covid-19: E-cigarettes, hookahs or tobacco - it may increase your risk

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  • Smoking in all its forms may increase your risk of contracting Covid-19.
  • This comparative research is the first in the world to investigate three methods of smoking.
  • Respiratory and cardiovascular diseases associated with smoking are comorbidities which can lead to severe Covid-19.

As the ban on the sale of tobacco products in South Africa continues, there is some debate on whether cigarette smoking directly affects your risk of getting Covid-19.

There have been investigations into the risk of smoking e-cigarettes vs traditional cigarettes, but there are few comparisons between the effects of e-cigarettes, hookahs (waterpipes) and traditional cigarettes.

Recently, however, a comparative study from the European Society of Cardiology investigated the effects of different methods of smoking, including e-cigarettes, tobacco cigarettes and hookahs, and found that they all play a role in causing inflammation and damage to DNA.

The research was published on 25 June in the European Heart Journal.

First comparison of three forms of smoking

This study is significant, as it’s the world’s first comparison of the effects of three forms of smoking on human health, and especially the function of cells in blood vessels, according to a news release.

The researchers stated that there was plenty of evidence to suggest that tobacco cigarettes were more harmful than e-cigarettes, but there was a lack of large studies on the true effects of waterpipes and e-cigarettes. They stressed that the long-term effects of these forms of smoking should be investigated to gain clarity about whether they are more harmful than traditional cigarettes.

According to the study, tobacco cigarettes increased the risk of COPD by 704%, waterpipes by 218% and e-cigarettes by 194%. The risk of lung cancer increased by 1 210% in the case of cigarettes, and 122% with e-cigarettes.

They also investigated the effect of these three smoking alternatives on the stiffening of arteries.

Additionally, the researchers looked at the main toxic chemicals present in e-cigarettes. According to the authors, nicotine is present in all three alternatives. Nicotine may have harmful and addictive effects on the body.

Smoking and Covid-19 – what is your risk?

According to the new research, both smoking and vaping (smoking e-cigarettes) may increase your risk of being infected by Covid-19 and suffering more severe symptoms than non-smokers. They suggest that health authorities urge those who smoke to try and quit, no matter whether they smoke traditional cigarettes, smoke waterpipes or vape.

They stated the following in the paper: "As outlined by the WHO, tobacco cigarette and waterpipe smoking may contribute to an increased burden of symptoms due to Covid-19 compared to non-smoking, including being admitted to intensive care, requiring mechanical ventilation, and suffering severe health consequences."

They also state that smoke cessation is the most powerful approach to prevent any smoking-induced health conditions such as cardiovascular and respiratory disease, and in the light of Covid-19, these are comorbidities that can significantly increase your risk of a more severe form of the illness.

"Given the well-established harms associated with tobacco use and secondhand smoke exposure, the WHO recommends that tobacco users should quit. Proven interventions to help users give up include toll-free quitlines, mobile text-messaging cessation programmes, nicotine replacement therapies and other approved medications, particularly if you have smoked for a long time, and especially if you use tobacco cigarettes and waterpipes.

"The WHO also warns that although e-cigarettes appear to be less harmful than tobacco cigarettes, there is growing evidence that they also may cause side effects in the lungs, heart and blood vessels and that e-cigarette use may increase the risk of Covid-19 infection," said leading study author Professor Thomas Münzel, of the Department of Cardiology of the University Medical Centre Mainz in a news release.

READ | Why smokers seem to be particularly vulnerable to severe Covid-19

READ | Why lighting up and Covid-19 don't mix

READ | Why the cigarette ban during lockdown? Five experts weigh in

Image credit: Thorn Yang from Pexels

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