tobacco smoking and covid 19 infection tobacco smoking and covid 19 infection

What are some practical steps primary HCPs can take? doi: 10.1111/jdv.16738. In South Africa, before the pandemic, the. Cigarette smoking and secondhand smoke cause disease, disability, and death. The report was published May 12, 2020, in Nicotine & Tobacco Research. And smoking has . Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. However, once infected an increased risk of severe disease is reported. Low incidence of daily active tobacco smoking in patients with symptomatic COVID-19. Low rate of daily active tobacco smoking in patients with symptomatic COVID-19. 2020. 41 found a statistically significant These studies, in which smoking status was not a primary exposure of interest, were subsequently brought together in several systematic reviews and meta-analyses19,20,21,22,23,24,25. "Past research has shown that smoking increases the risk of COVID-19 disease severity, but the risk of infection had been less clear," said UC Davis tobacco researcher and lead author of the study . Nine of the 18 studies were included Vardavas et al.40 analysed data from 5 studies totalling 1549 patients and calculated a relative risk that indicated a non-significant Google Scholar. OBJECTIVE During the state of alarm and once the confinement decreed by the COVID-19 pandemic ended, a cross-sectorial study was carried out in Spain between May 4th and 22nd, 2020 by volunteers who . Apr 23;S0163-4453(20)30234-6. https://doi:10.1016/j.jinf.2020.04.021 38. Interestingly, the scientists received mostly one patient file per hospital. A report of the Surgeon General. Mar 25. https://doi:10.1093/cid/ciaa242 20. Crit. Qeios. Dong X, Cao YY, Lu XX, Zhang JJ, Du H, Yan YQ, et al. And, so, it's very likely that people who are engaging in those behaviors are more likely to get the infection and spread it to others," says Dr. Hays. Zhang, J. J. et al. which are our essential defenders against viruses like COVID-19. Farsalinos, K., Barbouni, A. 2020 May;29(3):245-246. doi: 10.1136/tobaccocontrol-2020-055807. This cross-sectional study . Journal of Medical Virology. Clinical course and risk factors Kodvanj, I., Homolak, J., Virag, D. & Trkulja V. Publishing of COVID-19 preprints in peer-reviewed journals, preprinting trends, public discussion and quality issues. Rep. 69, 382386 (2020). Sheltzer, J. The https:// ensures that you are connecting to the DOI: https://doi.org/10.1016/S2213-2600(20)30239-3. Clinical Therapeutics. Grundy, E. J., Suddek, T., Filippidis, F. T., Majeed, A. Preprint at https://www.qeios.com/read/VFA5YK (2020). Cases with a history of smoking achieved a higher rate of COVID-19 disease progression as opposed to those having not smoked (OR 1.53, 95% CI 1.29-1.81, P < 0.00001), while no significant association could be found between smoking status and COVID-19 disease progression (OR 1.23, 95% CI 0.93-1.63, P = 0.15). The tobacco industry in the time of COVID-19: time to shut it down? Yang, X. et al. 2020. Smoking is associated with COVID-19 progression: a meta-analysis. "These findings may have implications for addressing tobacco use at the population level as a strategy for preventing COVID-19 infection," said Elisa Tong, senior author and UC Davis Department of Internal Medicine professor. Eighteen of the 26 observational studies containing data on smoking status by severity of COVID-19 outcomes. Karagiannidis, C. et al. Download Citation | Live to die another day: novel insights may explain the pathophysiology behind smoker's paradox in SARS-CoV-2 infection | The severe acute respiratory coronavirus 2 (SARS-CoV . The damage leads to a susceptibility for infection, including COVID-19, more so when combined with smoking; smoking induces the upregulation of the expression of ACE2, a receptor . According to the Global Center for Good Governance in Tobacco Control, the tobacco industry was actively involved in downplaying the role of smoking in COVID-19 by spreading claims that smoking or vaping protects against COVID-1910. N Engl J Med. 11. Bookshelf It seems the tobacco industry benefited from the (social) media hype, since exposure to claims about a protective effect of smoking was associated with an increase in tobacco consumption among Chinese citizens during the pandemic6. The tobacco epidemic is set to continue, despite assurances from many tobacco companies that smoke-free devices are safer than traditional cigarettes. The evidence remains inconclusive, but it seems that some public health experts and journalists don't want to get to the bottom of this mystery. The IP address used for your Internet connection is part of a subnet that has been blocked from access to PubMed Central. Zhang JJ, Dong X, Cao YY, Yuan YD, Yang YB, Yan YQ, et al. Apr 15. https://doi:10.1002/jmv.2588 36. Apr 27. https://doi.org/10.1016/j.clinthera.2020.04.009. Proven interventions to help users quit include toll-free quit lines, mobile text-messaging cessation programmes, Lancet. After all, we know smoking is bad for our health. Here, we suggest a few steps to help reduce tobacco use during this pandemic and hopefully long after. the exacerbation of pneumonia after treatment. eCollection 2022. Risk Factors Associated with Clinical Outcomes in 323 COVID-19 Hospitalized Patients in Wuhan, China. C, Zhang X, Wu H, Wang J, et al. The new analysis in Nature Medicine examined a comprehensive, prespecified set of cardiovascular outcomes among patients in the US Veterans Health Administration (VHA) system who survived the first 30 days of COVID-19. If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. A, Niaura R. Systematic review of the prevalence of current smoking among hospitalized COVID19 patients in China: could nicotine be a therapeutic option? Such studies are also prone to significant sampling bias. "Smoking is associated with substantially higher risk of COVID-19 progression," said Stanton A. Glantz, PhD, professor of medicine and director of the UCSF Center for Tobacco Control Research and Education. Get the most important science stories of the day, free in your inbox. many respiratory infections.2-4 In the COVID-19 pandemic, questions have been asked about clinical outcomes for smokers, and whether they are equally susceptible to infection, and if nicotine has any biological effect on the SAR-CoV-2 virus (the virus Smokers are 60%-80% more likely to be admitted to hospital with Covid-19 and also more likely to die from the disease, data suggests. This has led to claims that a 'smoker's paradox' may exist in COVID-19, wherein smokers are protected from infection and severe complications of COVID-19 . According to the CDC, wildfire smoke contains gas and particles of burned trees, vegetation and buildings. 2020. and JavaScript. This review therefore assesses the available peer-reviewed literature Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis. Also, many manuscripts did not initially follow the traditional time-consuming peer review process but were immediately shared online as a preprint. Tobacco causes 8 million deaths every year from cardiovascular diseases, lung disorders, cancers, diabetes, and hypertension.1 Smoking tobacco is also a known risk factor for severe disease and death from Moreover, there is growing evidence that smokers have worse outcomes after contracting the virus than non-smokers3. And exhaled e-cigarette vapor may be even more dangerous. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Note: Content may be edited for style and length. Review of: Smoking, vaping and hospitalization for COVID-19. Smoking and vaping lower the lung's immune response to infection. Arcavi, L. & Benowitz, N. L. Cigarette smoking and infection. 8600 Rockville Pike Journal of Korean Medical Science. Here we use two examples (one Chinese and one French study) to illustrate the most common problems with these studies. Chen Q, Zheng Z, Zhang Chen J, et al. Provided by the Springer Nature SharedIt content-sharing initiative, npj Primary Care Respiratory Medicine (npj Prim. Preprint at MedRxiv https://www.medrxiv.org/content/10.1101/2020.09.04.20188771v4 (2020). Much of the, Robust evidence suggests that several mechanisms might increase the risk of respiratory tract infections in smokers. Klemperer, E. M., West, J. C., Peasley-Miklus, C. & Villanti, A. C. Change in tobacco and electronic cigarette use and motivation to quit in response to COVID-19. Infect. Furthermore, 93% of all patients were categorised as: smoking status: never/unknown11. Lancet 395, 497506 (2020). All observational studies reported the prevalence of smoking amongst hospitalized COVID-19 patients. 2020 Jul;8(7):664-665. doi: 10.1016/S2213-2600(20)30239-3. https://doi:10.3346/jkms.2020.35.e142 19. May 3. https://doi:10.1093/cid/ciaa539 16. Archives of Academic Emergency Medicine. Thirty-four peer-reviewed studies met the inclusion criteria. 75, 107108 (2020). Lippi et al.38 analysed data from 5 studies totalling 1399 patients and found a non-significant association between smoking and severity. Accessibility Clinical characteristics of 145 patients with corona virus disease 2019 (COVID-19) in Taizhou, Zhejiang, China. Eur. CAS Epidemiological, clinical characteristics of cases of SARS-CoV-2 infection with abnormal imaging findings. Irrespective of COVID-19, smoking is uniquely deadly. Smoking marijuana, even occasionally, can increase your risk for more severe complications from Covid-19, the disease caused by the novel coronavirus. Global center for good governance in tobacco control. 8(5): 475-481. https://doi.org/10.1016/S2213-2600(20)30079-5 27. National and international media were interested in this story and we soon began receiving questions about this topic in general practice. He says the COVID-19 pandemic is an opportunity for people who smoke to recognize the serious health risks associated with the addiction and consider quitting. Given the well-established harms associated with tobacco use and second-hand smoke exposure;2 WHO recommends that tobacco users stop using tobacco. COVID-19 outcomes were derived from Public Health . The Lancet Oncology. Background: Identification of prognostic factors in COVID-19 remains a global challenge. Simons, D., Shahab, L., Brown, J. A university hospital in Paris appears to have collected their data more systematically: they asked 482 COVID-19 patients whether they smoked or had done so in the past, resulting in only 9 missing answers27. Content on this website is for information only. A, Mechanistic studies postulate that the increased susceptibility to infection might be due to upregulation of the angiotensin converting enzyme 2 (ACE2) receptor, the main receptor used by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to gain entry to host mucosa and cause active infectionan apparently unique mechanism to this virus. Smoking is known to increase the risk of infection of both bacterial and viral diseases, such as the common cold, influenza and tuberculosis1, and smoking is a putative risk factor for Middle East respiratory syndrome coronavirus infection2. across studies. Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, et al. ", The researchersre-analyzed data from the British Cold Study (BCS), a 1986-1989 challenge study that exposed 399 healthy adults to 1 of 5 "common cold" viruses. Addiction (2020). A HCPs advice for smoking cessation has always been very important, but in these COVID-19 times it is more urgent than ever before. 10 Another study of 323 hospitalized patients in Wuhan, China, reported a statistically significant association between smoking and severity of disease (OR 3.5 (95% CI 1.2 10.2).15 Kozak et al. and transmitted securely. Perhaps smoking-induced inflammation of the upper respiratory mucosa provides low-degree protection against transmission of viral infection. This included a type of common coronavirus (coronavirus 229E) that existed prior to the novel coronavirus (SARS-CoV-2 virus), which causes COVID-19 disease. COVID-19 attacks the lungs, and people who smoke or vape are at higher risk of developing lung infections. Y, Zhang Z, Tian J, Xiong S. Risk factors associated with disease progression in a cohort of patients infected with the 2019 novel coronavirus. Accessibility van Westen-Lagerweij, N.A., Meijer, E., Meeuwsen, E.G. Tob Control. 5-7 At the time of writing, one clinical trial to test the effects of nicotine has been announced, but no trial registration record was found as of 12 May 2020. Ned. 1 bij jonge Nederlanders: de sigaret. By Melissa Patrick Kentucky Health News. These include current smokers being more likely to get tested due to increased symptoms and smoking status being under-reported in electronic health records. Journal of Clinical Virology. Allergy. npj Prim. European Journal of Internal Medicine. 55, 2000547 (2020). Bethesda, MD 20894, Web Policies Scientists are still learning about the disease, but we know that: Being a current smoker increases your risk for severe illness from COVID-19. Collecting smoking history is challenging in emergency contexts and severity of disease is often not clearly defined and is inconsistent "Our communities . Epub 2020 Jul 2. A number of recent studies have found low percentages of smokers among COVID-19 patients, causing scientists to conclude that smokers may be protected against SARS-CoV-2 infection. CDC COVID-19 Response Team. Tob. and E.A.C. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Prevalence and Persistence of Symptoms in Adult COVID-19 Survivors 3 and 18 Months after Discharge from Hospital or Corona Hotels. The Lancet Respiratory Medicine. This was the first association between tobacco smoking and chronic respiratory disease. Smoking injures the local defenses in the lungs by increasing mucus . Materials provided by University of California - Davis Health. The South African government on Wednesday insisted that its current ban on tobacco products sales under the novel coronavirus pandemic lockdown was for the good health of all citizens. Lancet. French researchers are trying to find out. 2020. Factors associated with anxiety in males and females in the Lebanese population during the COVID-19 lockdown. Clinical Characteristics of Coronavirus Disease 2019 in China. Zheng Y, Xiong C, Liu Y, Qian X, Tang Y, Liu L, et al. 2022 Nov 22;10:985494. doi: 10.3389/fpubh.2022.985494. been published which pooled the prevalence of smokers in hospitalized patients across studies based in China. Induc. The association between smoking and COVID-19 has generated a lot of interest in the research community. Copyright 2023 Elsevier Inc. except certain content provided by third parties. A number of recent studies have found low percentages of smokers among COVID-19 patients, causing scientists to conclude that smokers may be protected against SARS-CoV-2 infection. The origins of the myth, https://doi.org/10.1038/s41533-021-00223-1. Smoking significantly worsens COVID-19, according to a new analysis by UC San Francisco of the association between smoking and progression of the infectious disease. Current smokers have. It's a leading risk factor for heart disease, lung disease and many cancers. 8600 Rockville Pike Smoking even just 1 cigarette a day increases your risk for heart disease and stroke, and damages your cilia. 2020. https://doi:10.1002/jmv.25783 26. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. The social behavior of smoking and vaping also can increase the risk of spreading the virus, as people who smoke or vape oftentimes do so in groups. Changeux J, Amoura Z, Rey F, Miyara M. A nicotinic hypothesis for Covid-19 withpreventive and therapeutic implications. JAMA Cardiology. However, it remains controversial with respect to the relationship of smoking with COVID-19. In France, researchers first suggested that nicotine may play a role in protecting smokers9, triggering a run on nicotine products among the general public. "A quarter of the U.S. population currently smokes or has high levels of cotinine, a nicotine metabolite, and there is no safe level of smoke exposure for nonsmokers. During the coronavirus disease (COVID-19) pandemic, the issue of tobacco smoking and risk for acute respiratory infection is again topical. FOIA Association Between Smoking and SARS-CoV-2 Infection: Cross-sectional Study of the EPICOVID19 Internet-Based Survey JMIR Public Health Surveill 2021;7(4):e27091 doi: 10.2196/27091 PMID: 33668011 PMCID: 8081027 Smoking is also a well-established risk fac-tor for chronic diseases that are linked to more severe COVID-19. J. Med. The .gov means its official. volume31, Articlenumber:10 (2021) Objective: The aim of this study was to identify changes in smoking behaviors along with the reasons thereof, 1 year after the pandemic started. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Are smokers protected against SARS-CoV-2 infection (COVID-19)? relationship between smoking and severity of COVID-19. National Library of Medicine Farsalinos et al. Res. Third, since exposure to health misinformation on social media is more common among youth and young adults6, primary HCPs may choose to actively bring up the subject of smoking and COVID-19 in consultations with youth and young adults and advise non-smokers to never start smoking. And, when it comes to the COVID-19 pandemic, the side effects of smoking and the behaviors of people who smoke or vape could create a one-two punch. Med. Lippi, G. & Henry, B. M. Active smoking is not associated with severity of coronavirus disease 2019 (COVID-19). Currently, no evidence suggests that e-cigarette use increases the risk of being infected by SARS-CoV-2. of COVID-19 patients in northeast Chongqing. Dis. Luk, T. T. et al. It's common knowledge that smoking is bad for your health. 2020;395(10229):1054-62. https://doi.org/10.1016/S0140-6736(20)30566-3 30. 2020. Epidemiology. University of California - Davis Health. disappeared when the largest study by Guan et al.13 was removed from the analysis (a sensitivity test to see the impact of a single study on the findings of the meta-analysis). J. Med. [A gastrointestinal overview of COVID-19]. However, the same authors found a statistically significant association between smoking status and primary endpoints of admission to Intensive Care Unit (ICU), ventilator use or death. HHS Vulnerability Disclosure, Help Office on Smoking and Health; 2014. in SARS-CoV-2 infection: a nationwide analysis in China. Ando W, Horii T, Jimbo M, Uematsu T, Atsuda K, Hanaki H, Otori K. Front Public Health. In the year to June 2020, 7.6% of smokers taking part in the survey quit - almost a third higher than the average and the highest proportion since the survey began more than a decade ago. The New England Journal of Medicine. 3. association. ciaa270. Care Med. on the association between smoking and COVID-19, including 1) risk of infection by SARS-CoV-2; 2) hospitalization with COVID-19; and 3) severity of COVID-19 outcomes amongst hospitalized patients such as admission into intensive care units (ICU), factors not considered in the studies. The double-edged relationship between COVID-19 stress and smoking: Implications for smoking cessation. Taxes on the sale of tobacco products provide enormous revenue for governments and the tobacco industry provides millions of jobs globally; but tobacco also causes death in 50% of consumers and places a heavy, preventable toll on health-care systems. The influence of smoking on COVID-19 infection and outcomes is unclear. 2020. The Lancet Regional Health Southeast Asia, The Lancet Regional Health Western Pacific, Pandemic: examining readiness for infectious disease outbreaks, We use cookies to help provide and enhance our service and tailor content and ads. Chow N, Fleming-Dutra K, Gierke R, Hall A, Hughes M, Pilishvili T, et al. 92, 797806 (2020). Methods We searched PubMed and Embase for studies published from January 1-May 25, 2020. In a meta-analysis of studies that included 11,590 COVID patients, researchers found that among people with the virus, the risk of disease progression in those who currently smoke . But given the devastating health effects of smoking, and the deep-pocketed tobacco industry's efforts to downplay the dangers of smoking, 4. 2020;94:81-7. https://doi.org/10.1016/j.ijid.2020.03.040 29. A new study led by UC Davis Comprehensive Cancer Center researchers shows that current smokers have a 12% increased risk of a laboratory-confirmed viral infection and a 48% increased risk of being diagnosed with respiratory illnesses. Observational studies have limitations. The authors of the French study suggest the mechanism behind the protective effects of smoking could be found in nicotine. Morbidity and Mortality Weekly Report. https://doi.org/10.3389/fcimb.2020.00284 43. First, in line with national guidelines, primary HCPs can choose to ask patients about their smoking status during consultations, inform smokers about the dangers of smoking, advise smokers to quit smoking and offer cessation support to all smokers. Smoking affects every system in your body. HHS Vulnerability Disclosure, Help Zhu W, Xie K, Lu H, Xu L, Zhou S, Fang S. Initial clinical features of suspected coronavirus disease 2019 in two emergency departments outside of Hubei, China. Careers. On . All included studies were in English. "We stand before Californians today with a humble message of thanks for taking the hard steps to help manage COVID-19, and with an ongoing commitment to be prepared for what comes next," said CDPH Director and State Public Health Officer Dr. Toms Aragn. 2020 Apr;162(8):59-60. doi: 10.1007/s15006-020-0431-x. Smoking, TB and Covid-19 are high prevalence entities with public health consequences and thus, a lethal triad. Tobacco and nicotine derivatives uses are multiple in nature. 2020. Since smoking is an avoidable risk factor for poor prognosis in COVID-19 infection, a national effort at smoking cessation, bolstering deaddiction services and supporting individuals in their efforts to quit tobacco use is an intervention that may be necessary to reduce demand for scarce resources - PPEs, ICU capacity, and ventilators. Dis. Several reports have claimed a smoker's paradox in coronavirus disease 2019 (COVID-19), in line with previous suggestions that smoking is associated with better survival after acute myocardial infarction and appears protective in preeclampsia. They reported only 5% of current daily smokers in their patient group. "Past research has shown that smoking increases the risk of COVID-19 disease severity, but the risk of infection had been less clear," said UC Davis tobacco researcher and lead author of the study Melanie Dove. Although it is clear that smoking is a risk factor for the severity of Covid-19, early studies reported an underrepresentation of smokers among patients hospitalized for Covid-19 [25]. B, Zhao J, Liu H, Peng J, et al. Patients and methods: Patients admitted to our Smoking Cessation Outpatient Clinic between March 1st, 2019, and March 1st, 2020, and registered in the Tobacco Addiction . Electrodes Grown in the Brain -- Paving the Way for Future Therapies for Neurological Disorders, Wireless, Soft E-Skin for Interactive Touch Communication in the Virtual World, Want Healthy Valentine Chocolates? During the coronavirus disease (COVID-19) pandemic, the issue of tobacco smoking and risk for acute respiratory infection is again topical. 8, e35 (2020). 2020. The impact of COPD and smoking history on the severity of COVID-19: a systemic review and meta-analysis. Characteristics of those who are hospitalized will differ by country and context depending on available resources, access to hospitals, clinical protocols and possibly other Clinical features and treatment Independent Oversight and Advisory Committee. Guan, W. J. et al. determining risk factor and disease at the same time). UC Davis tobacco researcher Melanie Dove. Apr 28:1-9. https://doi.10.1007/s15010-020- 01432-5 9. Prost K, Yip L, Williams V, Leis JA, Mubareka S. Severity of coronavirus respiratory tract infections in adults admitted to acute care in Toronto, Ontario. You are using a browser version with limited support for CSS. 92, 19151921 (2020). A review of studies by public health experts convened by WHO on 29 April 2020 found that smokers are more likely to develop severe disease with COVID-19, compared to non-smokers. Clinical infectious diseases : an official publication of the Infectious Diseases Society The finding that smoking is not associated with SARS-CoV-2 infection contradicts earlier studies which found that smokers are more vulnerable to infections in general and to respiratory infections in particular. 2020. The rates of daily smokers in in- and outpatients . The statistical significance Emami A, Javanmardi F, Pirbonyeh N, Akbari A. So, what research was this claim based on in the first place? Smoking im-pairs lung function and pulmonary immune function, compromising the body's defense mechanisms against infections [3]. Individual studies included in Due to the great need for knowledge about COVID-19 and the associated publication pressure, several manuscripts were quickly published in peer-reviewed journals without undergoing adequate peer review. with Coronavirus Disease 2019 (COVID-19) Outside Wuhan. Six meta-analyses were identified that examined the association between smoking and severity of COVID-19. The UC Davis researchers calculated overall and coronavirus-specific unadjusted and adjusted relative risks for current smokers and each outcome (infection and illness), testing whether each association was modified by type of respiratory virus. [Smoking and coronavirus disease 2019 (COVID-19)]. Med. Talk to your doctor or health care . Tijdschr. The studies also contained other major methodological flaws, including incompleteness of data (the majority of the studies had >20% missing data on smoking status3), selection bias28 and misclassification bias3. Sebastin Pea, Katja Ilmarinen, Sakari Karvonen, Pierre Hausfater, David Boutolleau, Florence Tubach, Erika Molteni, Christina M. Astley, Marc Modat, Gareth J. Griffith, Tim T. Morris, Gibran Hemani, Claire E. Hastie, David J. Lowe, Jill P. Pell, Viyaasan Mahalingasivam, Guobin Su, Dorothea Nitsch, Sofa Jijn, Ahmad Al Shafie, Mohamed El-Kassas, Helen Ward, Christina Atchison, Paul Elliott, npj Primary Care Respiratory Medicine The best way to stop smoking is to talk to your health care provider,make a planand stick to it, using many of the resources available, such as behavioral therapy and medications. Mo, P. et al. 2020. 2020. None examined tobacco use and the risk of infection or the risk of hospitalization. Zheng Z, Peng F, Xu Miyara, M. et al. While not smoking every day may seem like it's safer, there's no such thing as safe smoking. 2018;18(1):574. https://doi.org/10.1186/s12889-018-5484-8 4. 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Feb 19. https://doi:10.1111/all.14238 28. Recently, a number of observational studies found an inverse relationship between smoking and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (coronavirus disease 2019 (COVID-19)), leading to a (social) media hype and confusion among scientists and to some extent the medical community. Lippi G, Henry BM. Abstract. Image, COVID-19, smoking, and cancer: a dangerous liaison, The Lancet Regional Health Southeast Asia, Statement on offensive historical content. Smoking links to the severity of Covid-19: An update of a meta-analysis. Original written by Stephanie Winn. However, the epidemic is progressing throughout French territory and new variants (in particular . Kalak G, Jarjou'i A, Bohadana A, Wild P, Rokach A, Amiad N, Abdelrahman N, Arish N, Chen-Shuali C, Izbicki G. J Clin Med. May 9;1-8. https://doi:10.1007/s11739-020-02355-7 35. The highest achievable outcome in cross-sectional research is to find a correlation, not causation. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Interestingly, the lead author of this research has been funded by the tobacco industry in the past, and also other researchers who have made similar claims can be linked with the tobacco industry, indicating a possible conflict of interest.