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Every year on 31 May, World No Tobacco Day is celebrated to raise awareness on the dangers related to using tobacco and to encourage people to quit this bad habit and lead a healthier life. According to the WHO, this year's theme is "Commit to Quit" which aims to help 100 million people to quit tobacco by using various initiatives and digital tools and create healthier conditions that promote tobacco cessation.
Coronavirus has been a major concern since its outbreak due to its contagious nature. Lakhs of people have been infected worldwide out of which some have died and many have recovered. Medical experts say that people with a weak immune system, older adults and people with a preexisting medical condition are more prone to getting infected by COVID-19, which is true as the condition of these people gets worse in the presence of coronavirus. But one of the frequently asked questions is whether smokers are at higher risk of COVID-19 or not?
According to the World Health Organization, smokers are more vulnerable to COVID-19. This is because when smokers touch their mouth with contaminated fingers, the virus comes in contact with the mouth and enters the body. Also, when they share cigarettes, it facilitates the transmission of coronavirus to others.
Coronavirus And Smoking
People who smoke already have compromised lungs or respiratory system. It is because harmful particles from tobacco move deeply into the respiratory tract and get deposited into the alveoli of the lungs. The deposition of toxins or carcinogens increases the risk of cancer in the lungs including the mouth. 
COVID-19 is a disease that mainly affects the respiratory system of a person and causes mild to severe respiratory problems like shortness of breath, cough and pneumonia. Medical experts say that when coronavirus enters the respiratory tract, they first cause inflammation of the air passage followed by irritation of the lining of the airways. This result in a persistent cough and shortness of breath which are the mild symptoms of COVID-19.
If the condition progresses, the viruses reach the alveoli or air sacs and infect them too. Due to the infection of the alveoli, an inflammatory material is released in the air sacs which makes them inflamed. This inflammatory substance is usually in a fluid form. The condition leads to pneumonia as the body is unable to receive enough oxygen due to the deposition of fluid in the air sacs.
In the case of COVID-19, a large portion of the lungs gets affected. Even if the immune system tries to fight against the infection, they are unable to do so effectively as the viruses are new to the human body. However, the main concern is that people who already have compromised lungs due to smoking get the symptoms early compared to people who do not smoke.
Effects On Immunity
According to a study, approximately half of the adults who have a pneumococcal disease are smokers. Also, there is a 51% increased risk of pneumococcal disease in people who smoke cigarettes, 17% in people who are passive smokers as well as 14% in people with chronic diseases. 
If we look into the previous reports of Middle East respiratory syndrome coronavirus (MERS-CoV) that occurred in the year 2012, smokers and people with chronic obstructive pulmonary disease (COPD) got infected sooner compared to healthy individuals or people who do not smoke. A study published in the Journal of Clinical Infectious Diseases says that people who smoke have increased levels of a protein called Dipeptidyl peptidase-4 (DPP4) that makes lung cells more susceptible to getting infected by MERS coronavirus.
The Pain Point
There are many types of smokers like chain smokers, occasional smokers and passive smokers. The pain point is many occasional smokers think that as they smoke only one-two cigarettes a day, they are less prone to the infection than chain smokers. The same goes with passive smokers as they think they are unlikely to get any lung disease as they do not smoke. However, the irony is that they are all equally prone to coronavirus or any respiratory disease as chain smokers because their lungs are getting exposed to the carcinogens or toxins in one or the other ways. 
Coronavirus And E-Cigarettes
According to a study published in the Centre For Tobacco Control Research And Education by Stanton A. Glantz, PhD, exposure to e-cigarettes or vaping are also responsible to suppress the effect of the immune system in the body. The immunosuppressive effect of e-cigarettes is harmful at the gene level as it is known to alter the expression of more than 60 genes in our body. The study also suggests that e-cigarettes can impair the functionality of the neutrophil extracellular trap (NET) that help bind pathogens inside the body.
Advice For Smokers
Quitting smoking can be the best health decision of your life. We know that it requires a lot of mental determination to quit smoking but considering the fatal symptoms of COVID-19 infection, this is the best one could do to prevent the severe complications of the disease. Stopping smoking will not only improve lung function but will also make you less vulnerable to the COVID-19 that mainly affects the respiratory system of a person.
There a large group of smokers who might have thought to quit smoking someday while forgot to actually give it a second thought later. For those, this is the best time to quit smoking completely and start a healthy life.
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