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Covid-19 Primary Care Resources

Advice for smokers and vapers

Guidance and emerging evidence on risks of smoking, vaping and illness severity of Covid-19

This information is sourced from WHONHS UKthe Lancet and the Journal of Adolescent Health:


There is no robust evidence that smoking confers protection for Covid-19,  instead smoking appears to be a risk for Covid related disease severity

  • A meta-analysis of 34 peer reviewed studies suggests that smoking is associated with increased severity of disease and death in hospitalised Covid-19 patients
  • Smoking increases the risk of severe disease (relative risk [RR] 1·4 [95% CI 0·98–2·00]) and need for mechanical ventilation or death (RR 2·4 [1·43–4·04]) for current smokers
  • The largest study to date (pre-print), from the UK, reports an increased risk for death in current smokers compared with never-smokers of 1·25 (95% CI 1·12–1·40) when adjusted for age and sex
  • Smoking is a indicator for medical vulnerability for severe Covid related disease: 32% young adults (aged 18-25 yrs) who smoke have pre-existing conditions (cardiac, diabetic, immunological conditions etc)  which increase susceptibility to severe Covid-19 illness,  this compares to 16% of non-smoking young adults

Vaping (e-cigarettes)

Currently, no evidence suggests that e-cigarette use increases the risk of being infected by SARS-CoV-2

  • However, vaping involves repetitive hand-to-face movements, which provide greater risk of a route of entry into the body for viruses so hand washing is crucial and e-cigarettes should be cleaned regularly and vaping devices should not be shared
  • E-cigarettes can be an effective aid to stopping smoking and staying smokefree. It is currently unknown what effect vaping may have on susceptibility to severe disease if someone is infected with Covid-19, although the risk is likely to be much less than the risk of smoking

See also: Long term condition reviews


NHS UK Coronavirus advice for smokers and vapers

Published: 01/08/2020
WHO Smoking and COVID-19 Scientific Brief

Published: 30/06/2020
The Lancet Spotlight Tobacco smoking and COVID-19 infection

Published: 08/07/2020